[Does the care of diabetic patients with renal failure in the predialysis phase need improvement?].

Abstract

The cardiovascular risk profile was assessed in all 208 diabetics accepted for dialysis in 28 German dialysis centres from 1985-1987 (104 men, 104 women, mean age 60 [22-82] years). 71 patients had type 1 and 128 type 2 diabetes, and 9 maturity onset diabetes of the young. Of 169 patients, 164 (97%) had hypertension (median systolic blood pressure at start of dialysis 200 [120-280] mm Hg). Only 74 patients (44%) were on continuing anti-hypertensive medication. Median serum cholesterol was 225 (66-424) mg/dl, LDL-cholesterol 158 (43-335) mg/dl and HDL-cholesterol 32 (10-67) mg/dl. In patients with a history of myocardial infarction (n = 26) the median cholesterol concentration was 269 (126-424) mg/dl, while in those with no history of myocardial infarction (n = 132) it was 221 (66-280) mg/dl (P less than 0.05). Only 5% of the patients had received lipid lowering therapy. Out of 175 patients, 65 (37%) had a history of smoking, and 25 (14%) were still smokers at the start of dialysis. There was a strong association between smoking history and amputations. Only 98 of 208 patients (47%) had had a specialist ophthalmological examination in the 12 months preceding the start of dialysis. Proliferative retinopathy was present in 33 out of 53 (62%) type 1 and 15 out of 98 (15%) type 2 diabetics. Out of 22 patients with unilateral or bilateral blindness, 2 (10%) had received no photocoagulation. - This investigation reveals a need for better medical care of diabetics with pre-end-stage renal failure.

• Authors: M Koch, W Tschöpe, E Ritz
• Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 116 Issue 41 Pg. 1543-8 (Oct 11 1991) ISSN: 0012-0472 [Print] Germany
• Vernacular Title: Ist die Betreuung niereninsuffizienter Diabetiker in der prädialytischen Phase verbesserungsbedürftig?
• PMID: 1914932 (Publication Type: Clinical Trial, Comparative Study, English Abstract, Journal Article, Multicenter Study)

Chemical References

• Lipids
• Cholesterol

Topics

• Adult
• Aged
• Aged, 80 and over
• Cardiovascular Diseases (etiology)
• Cholesterol (blood)
• Diabetes Mellitus, Type 1 (blood, complications, therapy)
• Diabetes Mellitus, Type 2 (blood, complications, therapy)
• Diabetic Nephropathies (therapy)
• Female
• Humans
• Hypertension (etiology)
• Kidney Failure, Chronic (therapy)
• Lipids (blood)
• Male
• Middle Aged
• Renal Dialysis
• Risk Factors