Wednesday , September 28 2022

Five-fold higher risk of renal failure among low-skilled people


The risk of kidney failure in diabetes is five times higher for those who have not graduated from high school. Even the parents' education and family finances are important for the risk of renal failure, a dissertation at Umeå University shows.

"It may be that people with higher education and a better economy live a healthier life with better diets and more outdoor life so that they take care of their diabetes better than socio-economically vulnerable people. The challenge for care is to ensure that everyone has the same help and support to manage their diabetes regardless of background, says Cecilia Toppe.

Cecilia Toppe has used a number of national registries, such as the Swedish Childhood Diabetes Register, the National Diabetes Register and the Kidney Register, to study which type 1 diabetes patients develop kidney failure and need dialysis.

"We are seeing a positive development in health and survival for people with diabetes who suffer from kidney failure, but more emphasis must be placed on socio-economic factors such as economics and education so that everyone can benefit from the improvement," says Cecilia Toppe, PhD student at the Department of Clinical Science at Umeå University.

Among those who received type 1 diabetes such as children or adolescents, more than one in twenty, about five percent, suffered from renal failure requiring dialysis. Over time, fewer patients today develop kidney failure and they are at least three years older when they start dialysis than in the 90's. Those who suffer from kidney failure today also survive longer than those who received it in the 1990s or early 2000s. Best survival was seen in patients who received a new kidney with transplant, which received over half of patients with dialysis-requiring kidney failure in the study.

The single strongest socio-economic risk factor for developing kidney failure was the patient's own level of education. If you did not go to high school, there was a risk of kidney failure more than five times as if you had completed high school. When examining the risks at the parent level, it was possible to see that both the parents, but especially the mother, highest education were also a strong factor. There could also be a certain increased risk of kidney failure if someone in the family at some point had received social support.

What is kidney failure?

The kidneys clean the blood from substances and remove water that the body does not need. In renal failure, the kidneys no longer manage to do so, and then harmful substances and water remain in the body. Renal failure may be acute or chronic. In case of chronic renal failure, the function of the kidneys deteriorates slowly over several years. Acute renal failure develops sooner, within a few days or a couple of weeks. The most common form is chronic renal failure.

The thesis:
End stage renal disease in type 1 diabetes: time trends and risk factors

Cecilia Toppe, [email protected]

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