Does geographic location affect incidence of ANCA-associated renal vasculitis in northern Saskatchewan, Canada?

Objectives: To compare the incidence of renal ANCA-associated vasculitis (AAV) in urban vs more rural populations in northern Saskatchewan, and as a secondary objective to compare time to diagnosis between these geographic areas.

Methods: Northern Saskatchewan has a population of 562,882 of which approximately 260 600 live in the major urban area. A pathology database search for renal biopsy reports suggestive of AAV between January 2007 and December 2011 and subsequent chart review yielded 33 new diagnoses of granulomatosis polyangiitis (GPA) or microscopic polyangiitis (MPA).

Evidence for increased risk of prediabetes in the uremic patient.

A prediabetic state is defined as a higher than normal blood glucose level but not yet high enough to meet the diagnosis of overt diabetes mellitus. While patients with advanced diabetic nephropathy are vulnerable to hypoglycemia, we believe that there is sufficient evidence that uremic nondiabetic patients are susceptible to hyperglycemia, which calls for more attention that uremia is a prediabetic state. It is, therefore, intriguing to identify these uremic factors which lead to prediabetes.