[Experience with chronic hemodialysis in diabetic patients with kidney failure]

Abstract

Between 1978 and 1992, 534 patients--including 35 (25 IDDM and 10 NIDDM) diabetics--were accepted to chronic hemodialysis (HD) at our Dialysis Center. The 1-year cumulative survival rate (CSR) was significantly lower in diabetic vs. non-diabetic group (66 +/- 8% vs. 78 +/- 2%), p < 0.05). At the onset of diabetes the mean age of IDDM patients vs. NIDDM patients was 18.2 +/- 2.7 years vs. 51.3 +/- 3.1 years, respectively. At the beginning of HD treatment the mean age of IDDM patients vs. NIDDM patients was 38 +/- 2.4 years vs. 58.3 +/- 2.6 years. In IDDM group until the start of HD treatment the mean duration of diabetes was 20 +/- 1.3 years and it did not depend on the quality of preuraemic metabolic control (p = 0.825); mean duration of diabetes until their death was 22.5 +/- 1.3 years. Mean age of IDDM and NIDDM patients at their death was 38.8 +/- 3 years and 60.5 +/- 3.7 years. Average duration of HD treatment was 16 +/- 2.5 months in IDDM group and 21.5 +/- 5.8 months in NIDDM group. Major causes of death were cardiovascular complications of diabetes (39%) and infections (33%). We found no difference in CSR related to gender, age, type of diabetes, quality of metabolic control during the HD treatment, but CSR was significantly higher in patients with good metabolic control from the onset of diabetes (1-year CSR of adequately vs. poorly controlled diabetics: 80% vs. 62%, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)