Current status of Type 2 (non-insulin-dependent) diabetic subjects on dialysis therapy in Japan |
| |
Authors: | Dr R Kikkawa T Arimura M Haneda T Nishio K Sawada M Yagisawa Y Shigeta |
| |
Institution: | (1) Department of Medicine, Health Insurance Hospital of Shiga, Otsu, Japan;(2) Dialysis Unit, Ohmihachiman Municipal Hospital, Ohmihachiman, Japan;(3) Kidney Centre, Otowa Hospital, Kyoto, Japan;(4) Third Department of Medicine, Shiga University of Medical Science, 520-21 Sete, Otsu Shiga, Japan |
| |
Abstract: | Summary According to a national survey of dialysis patients in Japan conducted by the Japanese Society for Dialysis Therapy, there
were 1,033 patients on dialysis in the Shiga area which has a population of about 1.2 million. Of these 1,033 dialysis patients
140 were the result of diabetic nephropathy. From four hospitals affiliated to Shiga University of Medical Science the medical
records of 90 diabetic subjects on dialysis therapy were reviewed and various clinical parameters were analysed and compared
with those of patients with chronic glomerulonephritis. Since only one patient had Type 1 (insulin-dependent) diabetes, the
remaining 89 with Type 2 (non-insulin-dependent) diabetes were used for this study. The significantly different variables
between patients with Type 2 diabetes and chronic glomerulonephritis were age (60.4 vs 54.6 years,p<0.05), BMI (22.4 vs 20.6 kg/m2,p<0.001), cardiothoracic ratio (56.4 vs 53.3%,p<0.001), mean blood pressure (110 vs 117 mm Hg,p<0.05), serum creatinine (9.0 vs 11.5 mg/dl,p<0.001), serum urea-N (98.2 vs 115.5 mg/dl,p<0.001), serum total protein (6.0 vs 6.5 g/dl,p<0.001) and serum albumin (3.5 vs. 3.9 g/dl,p<0.001). Serum levels of cholesterol and triglyceride were not significantly different between two groups, though the prevalence
of electrocardiogram abnormalities, oedema, neuropathy, myocardial infarction and cerebrovascular diseases was significantly
higher in the Type 2 diabetic group. These results suggested that Type 2 diabetic patients with end-stage renal disease were
older, more malnurished, fluid overloaded and multi-morbid as a result of vasculopathy and neuropathy. However, the analysis
of causes of death in Type 2 diabetic patients (n=24) and patients with chronic glomerulonephritis (n=26) failed to provide evidence of higher risk of cardiac death in the Type 2 diabetic group compared to the group with chronic
glomerulonephritis (37.5 vs 34.6%, NS). In the Type 2 diabetic patients on dialysis therapy, malnutrition, fluid overload
and neuropathy appeared to be significant factors influencing the outcome of the therapy, while in patients with chronic glomerulonephritis,
age and vascular morbidities were considered to be major risk factors for the prognosis. |
| |
Keywords: | Type 2 (non-insulin-dependent) diabetes mellitus end-stage renal disease dialysis neuropathy mortality Japan chronic glomerulonephritis vasculopathy |
本文献已被 SpringerLink 等数据库收录! |
|