The treatment of diabetic kidney disease

Goetz, Frederick C.; Kjellstrand, Carl M.

doi:10.1007/bf01235882

Cited by 30 publications

(3 citation statements)

References 57 publications

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“…In the present study, five of the 69 patients had suffered some form of lower limb amputation, and one patient who had had neither dialysis nor transplantation needed amputation of fingers. Reports from Minneapolis also comment on these problems, noting that about one patient in five has an amputation after transplantation and that amputation of fingers occur almost exclusively amongst diabetic subjects [4,9]. Neuropathy also contributes to problems of the diabetic foot, and the large number (26%) of foot ulcers is additional cause for concern.…”

Section: Discussionmentioning

confidence: 99%

“…In the past, they have been rejected from dialysis or transplan- tation programmes because of these complications, although during the last decade workers in Minneapolis have demonstrated that these treatments are quite often successful [4]. The proportion of diabetic patients with end-stage renal failure who are not overwhelmed by the complications of their disease and therefore possible candidates for such active treatment is not known.…”

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confidence: 99%

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Mortality from diabetic nephropathy in the United Kingdom

et al. 1983

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Summary. Deaths in diabetic subjects dying under 50 years of age in the United Kingdom during 1979 have been analysed with special reference to diabetic nephropathy. Fifteen percent of 447 deaths were from nephropathy. Uraemic deaths from nephropathy were particularly common in those whose diabetes was diagnosed under 31 years old, and responsible for over one-quarter of deaths in this age group. Most deaths from nephropathy occur before 30 years' duration of diabetes and are rare in those of longer duration, suggesting that some diabetic patients are more and others less prone to this complication. There were more men than women in a ratio of approximately 1.3:1. Severe retinopathy is usually present in end-stage renal failure causing blindness in one out of three cases, and impaired vision in a further one out of three. Blind patients were not otherwise more severely affected by diabetic complications than others. It is estimated that approximately three-quarters of the diabetic subjects who develop end-stage renal failure from nephropathy may be suitable for dialysis or transplantation.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Mortality from diabetic nephropathy in the United Kingdom

et al. 1983

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“…In general, diabetic patients appear to tolerate renal failure poorly. That is, they develop symptoms and complications of uremia at higher glomerular filtrations rates.2 2 Previously, diabetic patients were excluded from various treatments of end stage renal disease such as dialysis and transplantation because of the increased incidence of complications that include retinopathy, myopathy, The procedure is as follows: A permanent silastic catheter is placed into the peritoneal cavity (Fig. 1) .…”

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confidence: 99%

Continuous Ambulatory Peritoneal Dialysis as a Treatment For Diabetic Patients With End Stage Renal Disease

et al. 1983

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Continuous ambulatory peritoneal dialysis (CAPD) is becoming the treatment of choice for many diabetics with end stage renal disease (ESRD). Hypertension is better controlled, neuropathy and vascular calcifications remains stable or improve, and few dietary or fluid restrictions are necessary. It is estimated that about 20% of all patients with ESRD will be using CAPD by 1985. Approximately 50 % of deaths in insulin dependent diabetics (and 6 ~o in insulin independent diabetics) 1 are due to renal failure. In general, diabetic patients appear to tolerate renal failure poorly. That is, they develop symptoms and complications of uremia at higher glomerular filtrations rates.2 2 Previously, diabetic patients were excluded from various treatments of end stage renal disease such as dialysis and transplantation because of the increased incidence of complications that include retinopathy, myopathy, neuropathy, peripheral vascular disease and cardio-vascular complications. Recently, however, more diabetic patients are being accepted into various transplant and dialysis programs. To date, survival rates and rehabilitation results have been discouraging for the end stage renal patient due to diabetes. At three years on hemodialysis, survival rates are approximately 35-50% compared to 75-85% survival in nondiabetics.' Blood glucose control in general is poor.' The majority of diabetic patients receiving hemodialysis tend to have a progression of their various other complications causing poor rehabilitation and often self

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