Abstract
The study compared the mortality of IDDM patients with onset age of less than 18 years due to diabetic renal disease between Japan and Allegheny County, PA, the U. S. In Japan, 16 of 1394 died due to this condition, in contrast to only 2 of 986 in the U. S., a ten-fold increased risk of dying in Japanese cohort.(Age-adjusted mortality rate for renal disease: Japan vs. the U. S., 276.7 vs.22.8/100, 000 person-years). There was geographic variation in Japan, with the total and renal disease mortality associated inversely with socioeconomic status of the area, estimated by an average yearly income per person.
The reasons for the extremely high renal disease mortality in Japan are unclear. Hypotheses include differences in the incidence of renal disease, differences in the genetic susceptibility for renal disease and differences in the delivery of diabetes care between the two populations. There are a number of research avenues scientists could pursue at this time to explain the mortality differential observed. Collaboration within established multinational studies, such as the WHO DIAMOND study, ensures the application of standardized techniques and methods which can uncover important clues regarding renal disease mortality among IDDM cohorts: a potent, and possibly preventable, killer.
