ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
|
|
|
Diabetes Mellitus And Dialysis
Dr. Arzu AKGÜL,a Dr. Siren SEZERa
aNefroloji Kliniği, Başkent Üniversitesi Tıp Fakültesi, ANKARA
Diabetes mellitus is one of the most common causes of end-stage renal disease (ESRD) and the proportion of diabetic ESRD patients is gradually increasing each year. Although, renal replacement therapy has improved the quality of life and survival of daibetic patients in the recent years, the prognosis of diabetic patients remains to be worse than nondiabetics, which may be explained by higher incidence of cardiovascular diseases in the diabetics. It is hard to say whether hemodialysis or peritoneal dialysis is the best choice for diabetic dialysis patients. Hemodialysis is still the most common renal replasman treatment modality in daibetic dialysis patients; however, clinical problems such as vasculer access problems and intradialytic hypotension during hemodialysis are quite frequent. Besides, complications such as increased peritoneal membrane permeability and ultrafiltration failure may occur in diabetic peritoneal dialysis patients, ultimately leading to increased technique failure. There are several factors -better blood pressure control and improved diabetes control by intraperitoneal insulin- favoring peritoneal dialysis as the initial dialytic therapy for diabetic ESRD patients. It is evident that the mortality is reduced in young diabetic patients on peritoneal dialysis in comparison to those on hemodialysis. Recently, improved prognosis of diabetic ESRD patients after renal transplantation is observed and transplantation may be considered as the first choice for diabetic patients. However, the frequency of renal transplantation among diabetic patients is still below the desired levels. Medical care of diabetic dialysis patients is very difficult and necessitates a multidiciplinary approach.Keywords: Renal failure, dialysis, diabetes mellitusTurkiye Klinikleri J Int Med Sci 2006, 2(4):90-96
|
|
|
|
|
