Over the past three decades there have been numerous innovations, supported by large outcome trials that have resulted in improved blood glucose and blood pressure control, ultimately reducing cardiovascular (CV) risk and progression to nephropathy in type 1 diabetes (T1D) (1,2). The epidemiological data also support the concept that 25–30% of people with T1D will progress to end-stage renal disease (ESRD). Thus, not everyone develops progressive nephropathy that ultimately requires dialysis or transplantation. This is a result of numerous factors, including the competing CV risk of death as well as blood glucose and pressure control. Good glycemic and blood pressure control have been documented in long-term trials to markedly slow nephropathy progression, with effects of blood pressure control seen as early as 2.5 years and of glucose control at 5–7 years (3,4). It is well documented that the presence of diabetic kidney disease increases the risk of CV events and death in persons with diabetes (5,6). Moreover, this is independent of hypertension. Data from two recent studies reported in this issue of Diabetes Care examine the long-term incidence of chronic kidney disease (CKD) in T1D. Costacou and Orchard (7) examined a cohort of 932 people evaluated for 50-year cumulative kidney complication risk in the Pittsburgh Epidemiology of Diabetes Complications study. They used both albuminuria levels and ESRD/transplant data for assessment. By 30 years’ duration of diabetes, ESRD affected 14.5% and by 40 years it affected 26.5% of the group with onset of T1D between 1965 and 1980. For those who developed diabetes between 1950 and 1964, the proportions developing ESRD were …

中文翻译：

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如果所有1型糖尿病患者的寿命都足够长，他们是否打算进行透析？可能不是

在过去的三十年中，在大型结果试验的支持下进行了许多创新，这些试验改善了血糖和血压控制，最终降低了1型糖尿病（T1D）的心血管（CV）风险和发展为肾病（1,2 ）。流行病学数据还支持25％至30％的T1D患者将发展为终末期肾病（ESRD）的概念。因此，并不是每个人都发展出进行性肾病，最终需要透析或移植。这是多种因素共同作用的结果，包括竞争性CV死亡风险以及血糖和压力控制。在长期试验中已证明良好的血糖控制和血压控制可显着减慢肾病的进展，而控制血压的作用最早可早于2。5年，血糖控制在5-7年（3,4）。有充分的证据表明，糖尿病性肾脏疾病的存在增加了糖尿病患者发生心血管事件和死亡的风险（5,6）。而且，这与高血压无关。来自本期《糖尿病护理》杂志的两项最新研究的数据检验了T1D中慢性肾脏病（CKD）的长期发生率。Costacou和Orchard（7）在匹兹堡糖尿病并发症流行病学研究中检查了932名评估50年累积肾脏并发症风险的人群。他们使用蛋白尿水平和ESRD /移植数据进行评估。在1965年至1980年期间，ESRD患糖尿病的时间为30％，而ESRD感染的人群为14.5％；到40年，其影响的人群为T1D发作的人群的26.5％。对于1950年至1964年之间患糖尿病的人群，