Risk for @entity454 in type 1 XXXX remains high despite renoprotection.

@entity1 @entity6 @entity470 @entity177 @entity65 @entity454
Historically, @entity1 with type 1 @entity6 and macroalbuminuria had high competing risks: @entity65 or @entity177 . Here, we assessed these risks in @entity1 receiving therapies implemented during the last 30 years. Between 1991 and 2004, we enrolled 423 white @entity1 with type 1 @entity6 who developed macroalbuminuria (albumin excretion rate, >= 300  g/min). With follow-up for 98% through 2008, @entity454 developed in 172 @entity1 (incidence rate, 5.8/100 @entity1 -years), and 29 died without @entity454 (mortality rate, 1/100 @entity1 -years). The majority of these outcomes occurred between ages 36 and 52 years with durations of @entity6 of 21 to 37 years. The 15-year cumulative risks were 52% for @entity454 and 11% for pre- @entity454 death. During the 15 years of follow-up, the use of renoprotective treatment increased from 56 to 82%, and BP and lipid levels improved significantly; however, the risks for both @entity454 and pre- @entity454 death did not change over the years analyzed. There were 70 post- @entity454 deaths, and the mortality rate was very similar during the 1990s and the 2000s (11/100 @entity1 -years versus 12/100 @entity1 -years, respectively). Mortality was low in @entity1 who received a pre-emptive kidney transplant (1/100 @entity1 -years), although these @entity1 did not differ from dialyzed @entity1 with regard to predialysis @entity470 , sex, age at onset of @entity454 , or duration of @entity6 . In conclusion, despite the widespread adoption of renoprotective treatment, @entity1 with type 1 @entity6 and macroalbuminuria remain at high risk for @entity454 , suggesting that more effective therapies are desperately needed.
