[Which method of dialysis for the type 2 diabetic?]

Abstract

Type 2 diabetes is becoming a major cause of chronic renal failure leading to health care problem. Literature data do not allow to choose between hemodialysis or peritoneal dialysis as the treatment of choice of end stage renal failure in type II diabetic patients according to their co-morbidities. A retrospective study was performed in 28 type II diabetic patients, either 11% of the total population, who started dialysis in our center between 1994 and 1997. Fourteen patients had chosen peritoneal dialysis and 14 hemodialysis. The 2 groups were not different for their initial neurological, cardiovascular, ophthalmological complications and for their metabolic control. After a mean follow-up of 14 months on dialysis a significant higher number of infections (9 versus 4), of hospitalisation days (34 +/- 19 versus 6.5 +/- 5.5), of technical transfers (6 versus 0) and of deaths (5 versus 0) were recorded in patients on peritoneal dialysis, without any difference in the metabolic control. A prospective, multicenter study is required to identify the best dialysis technique in type 2 diabetic patients, according to their co-morbidities and the dialysis dose.