Insulin resistance in patients undergoing peritoneal dialysis: can we improve it? : editorial to: 'the effect of HM-CoA reductase inhibitor on insulin resistance in patients undergoing peritoneal dialysis' by Fa Mee Doh et al.

摘要

Since 1972, there has been rapid growth in the end-stage renal disease (ESRD) program with the current growth rate between 5 and 7 % per year. A recent report from the United States Renal Data System (USRDS) has indicated that there are over 410,000 maintenance dialysis patients, with Medicare expenditures of over 30 billion dollars to support the ESRD program in the year 2010. Approximately 30 % of this total cost is due to hospitalization, which averages 14 days per patient year. Moreover, despite the many technical advances that have occurred in the delivery of dialysis therapy, the mortality rate of patients with ESRD remains high at over 20 % per year. Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in the United States and the presence of chronic kidney disease (CKD) is now recognized as an independent risk predictor for cardiovascular events. This is especially observed in advanced CKD such that CVD accounts for more than 40%of all deaths in the maintenance dialysis population .