Treatment of end-stage diabetic nephropathy: over a decade of experience at one institution

Results of treatment of end-stage renal disease in 139 patients with diabetes mellitus revealed survival of 76% at 1 year and 48% at 5 years. These results compare favorably with other reports from Europe and the United States, probably because of the greater number of patients receiving renal trans...

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Bibliographic Details
Published in:Medicine (Baltimore) 1984-09, Vol.63 (5), p.311-317
Main Authors: Zimmerman, S W, Glass, N, Sollinger, H, Miller, D, Belzer, F
Format: Article
Language:English
Subjects:
Adult
Age Factors
Diabetic Nephropathies - mortality
Diabetic Nephropathies - therapy
Female
Hemodialysis, Home
Humans
Kidney Failure, Chronic - mortality
Kidney Failure, Chronic - therapy
Kidney Transplantation
Male
Middle Aged
Peritoneal Dialysis - methods
Peritoneal Dialysis, Continuous Ambulatory
Renal Dialysis
Retrospective Studies
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Summary:Results of treatment of end-stage renal disease in 139 patients with diabetes mellitus revealed survival of 76% at 1 year and 48% at 5 years. These results compare favorably with other reports from Europe and the United States, probably because of the greater number of patients receiving renal transplants, and possibly because of the use of continuous ambulatory peritoneal dialysis as a recent treatment modality. Patients not receiving transplants were much older (mean age, 47.8 years) than those receiving transplants. Of those not given transplants, survival was best on CAPD. Comparison of those surviving at least 3 years was made with those expiring in the first year. Long-term survivors were younger, had diabetes for a shorter period, but had higher mean blood pressures and serum creatinine values than short-term survivors. Short-term survivors also had over a 50% incidence of prior myocardial infarction or cardiorespiratory arrest, while no long-term survivors had such a history. Long-term survivors were also more likely to have received a transplant, and short-term survivors were more likely to have received intermittent peritoneal dialysis or hemodialysis. A transplant from a living related donor is the treatment of choice for diabetics under age 40 and perhaps for older patients as well. The choice among CAPD, hemodialysis and cadaver transplant requires consideration of many factors.
ISSN:0025-7974
DOI:10.1097/00005792-198409000-00005