Despite 30 years of significant improvements in the care of patients with type 1 diabetes
(T1D), the risk of end-stage renal disease (ESRD) in these patients in the United
States has increased rather than decreased, although it now occurs at slightly older
ages. Furthermore, the competing risk of mortality from other causes (including cardiovascular
disease) for patients with diabetic nephropathy has proved to be a relatively minor
competitor. Therefore, ESRD has become the major contributor to the excess morbidity
and premature mortality of patients with T1D. This state of affairs is a call to action
and the rationale for this special issue of Seminars in Nephrology.
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© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
