Decreasing Cumulative Incidence of End-Stage Renal Disease in Young Patients With Type 1 Diabetes in Sweden: A 38-Year Prospective Nationwide Study

Diabetes Care. 2019 Jan;42(1):27-31. doi: 10.2337/dc18-1276. Epub 2018 Oct 23.


Objective: Diabetic nephropathy is a serious complication of type 1 diabetes. Recent studies indicate that end-stage renal disease (ESRD) incidence has decreased or that the onset of ESRD has been postponed; therefore, we wanted to analyze the incidence and time trends of ESRD in Sweden.

Research design and methods: In this study, patients with duration of type 1 diabetes >14 years and age at onset of diabetes 0-34 years were included. Three national diabetes registers were used: the Swedish Childhood Diabetes Register, the Diabetes Incidence Study in Sweden, and the National Diabetes Register. The Swedish Renal Registry, a national register on renal replacement therapy, was used to identify patients who developed ESRD.

Results: We found that the cumulative incidence of ESRD in Sweden was low after up to 38 years of diabetes duration (5.6%). The incidence of ESRD was lower in patients with type 1 diabetes onset in 1991-2001 compared with onset in 1977-1984 and 1985-1990, independent of diabetes duration.

Conclusions: The risk of developing ESRD in Sweden in this population is still low and also seems to decrease with time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Infant
  • Insulin / therapeutic use
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / therapy
  • Male
  • Proportional Hazards Models
  • Prospective Studies
  • Registries
  • Renal Replacement Therapy
  • Sweden / epidemiology
  • Young Adult


  • Insulin