Maladies rénales liées aux diabètes : épidémiologie et coûts

In industrialized countries, renal epidemiology is faced with the growing epidemic of diabetes as cause of renal involvement or as an associated condition. In France, recent studies estimate that 400,000 diabetics have a glomerular filtration rate lower than 60ml/min/1.73 m2, and that 7000 are prevalent in dialysis. In type 1 diabetes, renal prognosis improved over the last decades due to available aggressive glycemic control and treatment with renin-angiotensin system inhibitors. Survival of end-stage renal disease diabetic patients remains poor, whereas access to renal transplant is low for type 2 diabetes patients. Estimated costs for dialysis treatment of diabetic patients are around 750 million euros a year in France. Associated with therapeutic and dietetic weapons, therapeutic education collaborations and telemedicine technologies should be useful for better patient and practitioner involvement in cares, outcome improvement and lowering costs.