The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Chronic Renal Failure in Non-Insulin-Dependent Diabetes Mellitus: A Population-Based Study in Rochester, Minnesota

Linda L. Humphrey, MD, MPH; David J. Ballard, MD, MSPH; Peter P. Frohnert, MD; Chu-Pin Chu, MS; W. Michael O'Fallon, PhD; and Pasquale J. Palumbo, MD
[+] Article, Author, and Disclosure Information

Grant Support: Supported in part by research grants from the American Diabetes Association and the National Institutes of Health (AR-30582), the Juvenile Diabetes Foundation (JDF-5), and the Diabetes Research and Education Foundation (Diabetes-2).

Requests for Reprints: David J. Ballard, MD, Department of Health Sciences Research, Mayo Clinic, 200 SW First Street, Rochester, MN 55905.

Current Author Addresses: Dr. Humphrey: Division of General Medicine, Portland Veterans Administration Medical Center, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97207.

Dr. Ballard: Department of Health Sciences Research, Section of Clinical Epidemiology, Mayo Clinic, Rochester, MN 55905.

Dr. Frohnert: Department of Internal Medicine, Division of Nephrology and Internal Medicine, Mayo Clinic, Rochester, MN 55905.

Ms. Chu and Dr. O'Fallon: Department of Health Sciences Research, Section of Biostatistics, Mayo Clinic, Rochester, MN 55905.

Dr. Palumbo: Department of Internal Medicine, Division of Endocrinology/Metabolism and Internal Medicine, Mayo Clinic, Rochester, MN 55905.

©1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;111(10):788-796. doi:10.7326/0003-4819-111-10-788
Text Size: A A A

Study Objective: To identify the incidence of clinically defined chronic renal failure by clinical type of diabetes in a community diabetic incidence cohort, and to evaluate the relation between persistent proteinuria and chronic renal failure in non-insulin-dependent diabetes mellitus.

Design: Retrospective incidence cohort study.

Setting: Population-based in Rochester, Minnesota.

Patients: Residents of Rochester, Minnesota, with diabetes initially diagnosed between 1945 and 1979 who had follow-up to 1984 for clinically defined chronic renal failure.

Measurements and Main Results: Among 1832 persons with non-insulin-dependent diabetes who were initially free of chronic renal failure, 25 developed chronic renal failure (incidence, 133 per 100 000 person-years; CI, 86 to 196). The subsequent incidence of chronic renal failure among 136 insulin-dependent diabetic Rochester residents, three of whom developed chronic renal failure, was 170 per 100 000 person-years (CI, 35 to 497). After adjusting for potential confounding factors, we found that the risk for chronic renal failure associated with the presence of persistent proteinuria at the time of the diagnosis of non-insulin-dependent diabetes was increased 12-fold (hazard ratio, 12.1; CI, 4.3 to 34.0). When persistent proteinuria developed after the diagnosis of non-insulin-dependent diabetes mellitus, the cumulative risk for chronic renal failure 10 years after the diagnosis of persistent proteinuria was 11%.

Conclusions: These population-based data suggest that most cases of chronic renal failure in diabetes occur in persons with non-insulin-dependent diabetes. These data also identify the increased risk for chronic renal failure among persons with non-insulin-dependent diabetes mellitus who have persistent proteinuria present at or developing after the diagnosis of non-insulin-dependent diabetes mellitus; such data may be useful for directing interventions to prevent or delay the development of chronic renal failure.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.