Coronary Artery Disease in Diabetic Patients with End-Stage Renal Disease

Abstract

Diabetes mellitus is no longer considered a contraindication for end-stage renal disease care. In fact, in some centers approximately 20% of all new patients with uremia accepted into treatment programs have diabetic nephropathy as a primary diagnosis. Although some investigators have reported excellent patient survival in diabetic patients undergoing renal transplantation,⁽¹⁾ other recent data have been less favorable, pointing out some selection bias in the previous results. It is uniformly accepted that both maintenance hemodialysis and renal transplantation in diabetic patients are associated with excessive mortality over that expected in nondiabetic subjects.^(1–4) Much of the mortality observed in this high-risk group of patients is attributable to cardiovascular disease despite the relatively young age of many of these patients.