Hemodialysis and CAPD in Type I and Type II Diabetic Patients with Endstage Renal Failure

  • Eberhard Ritz
  • Michael Schömig

Abstract

In the early days of hemodialysis, efforts to treat and rehabilitate uremic patients with diabetes were largely unsuccessful [1] until dialysis procedures and particularly volume control had become more effective. Although diabetic patients have a poorer outcome than non-diabetic patients, survival has improved progressively, although long-term survival is still very unsatisfactory, e.g. at 5 years 38% in type I and 5% in type II diabetics in Germany [2], as shown in fig. 40-1. International comparison of survival (table 40-1) shows that survival of diabetics on renal replacement therapy goes in parallel with differences between country of cardiovascular deaths in non-uremic diabetics and in the general population [3]. It is certainly no longer justified, however, to deny admission to renal replacement therapy to any patient because of his or her diabetes [4]. The rising number of admissions of diabetic patients for renal replacement therapy is a medical catastrophe of world-wide dimensions [3]. It will require intense efforts in the predialytic phase to delay progression and to prevent complications, mainly cardiovascular, which later on jeopardise survival on dialysis [5–7].

Keywords

Cholesterol Obesity Europe Angiotensin Smoke 

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Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Eberhard Ritz
    • 1
  • Michael Schömig
    • 1
  1. 1.Medizinische KlinikRuperto Carola University HeidelbergGermany

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