OBJECTIVE End-stage renal disease (ESRD) is one of the most severe complications in type 1 diabetes. We aimed to estimate the cumulative incidence of ESRD in individuals with childhood-onset type 1 diabetes followed for up to 42 years. RESEARCH DESIGN AND METHODS Data were based on the nationwide, population-based Norwegian Childhood Diabetes Registry and included case patients with new-onset type 1 diabetes (age <15 years) who had received a diagnosis during the periods 1973–1982 and 1989–2012. Follow-up took place until the development of ESRD, death, emigration, or 30 November 2015. We estimated the cumulative incidence of ESRD by linking to the Norwegian Renal Registry. RESULTS Among the 7,871 patients, representing 147,714 person-years of follow-up, ESRD developed in 103 individuals (1.3%). The mean time from the diagnosis of diabetes to the development of ESRD was 25.9 years (range 12.7–39.1). The cumulative incidence of ESRD was 0.7% (95% CI 0.4–1.0) at 20 years’ diabetes duration, 2.9% (2.3–3.7) at 30 years’ duration, and 5.3% (4.3–6.5) at 40 years’ duration. The risk of the development of ESRD was lower in women than in men (hazard ratio [HR] 0.61; 95% CI 0.41–0.91) and higher in individuals in whom diabetes had been diagnosed at 10–14 years of age compared with those in whom it was diagnosed before 10 years of age (HR 1.29; 1.06–1.56). We did not identify any significant difference in the risk of the development of ESRD between those in whom diabetes was diagnosed in 1973–1982 and in 1989–2012 (HR 0.80; 0.45–1.45). CONCLUSIONS We report a very low incidence of ESRD among patients with childhood-onset diabetes in Norway. The risk was lower in women compared with men and in individuals in whom diabetes was diagnosed at a younger age.

中文翻译：

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随访长达42年的儿童期1型糖尿病终末期肾脏疾病的发生率低

目的终末期肾脏疾病（ESRD）是1型糖尿病中最严重的并发症之一。我们旨在评估在长达42年的儿童期1型糖尿病患者中ESRD的累积发生率。研究设计和方法数据基于全国，以人群为基础的挪威儿童糖尿病登记处，并包括在1973–1982年和1989–2012年期间被诊断出的新发1型糖尿病（年龄<15岁）的病例患者。进行随访直至ESRD发生，死亡，移民或2015年11月30日。我们通过与挪威肾脏病登记处联系来估算ESRD的累积发病率。结果在7,871名患者中，代表了147,714人-年的随访，其中有103名患者（1.3％）出现了ESRD。从诊断出糖尿病到ESRD发生的平均时间为25.9年（范围为12.7-39.1）。糖尿病20年时ESRD的累积发生率为0.7％（95％CI 0.4-1.0），30年时为2.9％（2.3-3.7），40年时为5.3％（4.3-6.5）。与男性相比，女性患ESRD的风险要比男性低（危险比[HR] 0.61； 95％CI 0.41–0.91），而被诊断患有糖尿病的个体在10–14岁时则较高。在10岁之前被诊断为谁（HR 1.29； 1.06-1.56）。我们没有发现1973–1982年和1989–2012年诊断出糖尿病的ESRD发生风险之间存在显着差异（HR 0.80; 0.45–1.45）。结论我们报道挪威儿童期糖尿病患者中ESRD的发生率非常低。