<b>Objective</b>: The long-term risk of end-stage kidney disease (ESKD) in type 2
diabetes is poorly described, as is the effect that younger age of diabetes
onset has on this risk. Therefore, we aimed to estimate the effect of age of
onset on the cumulative incidence of ESKD from onset of type 2 diabetes.
<p><b>Research Design and Methods: </b>This study included 1,113,201 people with
type 2 diabetes registered on the Australian National Diabetes Services Scheme
(NDSS) followed from 2002 until 2013. The NDSS was linked to the Australia and
New Zealand Dialysis and Transplant Registry and the Australian National Death
Index. </p>
<p><b>Results: </b>Between 2002 and 2013,<b> </b>there
were 7,592 incident cases of ESKD during 7,839,075 person-years of follow up. In
the first 10-15 years following onset of diabetes, the incidence of ESKD was
highest in those with an older age of onset of diabetes, whereas over longer
durations of diabetes the incidence of ESKD became higher in those with
younger-onset diabetes. After 40 years of diabetes, the cumulative incidence of
ESKD was 11.8% and 9.3% in those diagnosed with diabetes aged 10-29 and 30-39
years, respectively. When death from ESKD without renal replacement therapy was
included, incidence of ESKD remained higher in older onset diabetes for the
initial 20 years, with no clear effect of age thereafter.</p>
<p><b>Conclusions: </b>The long-term risk of ESKD in type 2 diabetes is high,
which disproportionately affects those with younger-onset of diabetes as they
are more likely to survive to longer diabetes durations.</p>
The Association Between Age of Onset of Type 2 Diabetes and the Long-term Risk of End-Stage Kidney Disease: A National Registry Study
