Abstract
Over the past 10 years, we have retrospectively investigated on dialytic therapy of 62 cases of diabetics at our department and our associated hospital. We studied the complications and the cause of death of 62 subjects. Of 62 patients (male 42, female 20), 27 patients (male 21, female 6) were died. The cause of death in 27 cases included 7 general weakness, 4 gastrointestional bleeding, 4 cerebrovascular hemorrhage or thrombosis, 3 suicide, congestive heart failure, 2 myocardial infarction, 2 hyperkalemia, 1 infection and 1 hepatoma.
The cererovascular accident often occurred at the early stage of hemodialysis and gastro-intestinal bleeding and general weakness occurred after that.
With regard to diabetic retinopathy, nineteen of 62 patients were bilateral blind and 12 patients were unilateral blind. In 8 patients, visual complications developed after hemodialysis, but 16 patients had been already blind when hemodialysis was introduced.
We didn't find the evidence that the retinopathy was accelerated by dialysis. We suggest that the treatment of retinopathy is very important at nondialyzed stage.
With regard to the other complications of dialyzed diabetics, we could find unstable hypertension, diabetic gastroenteropathy, periferal neuropathy, ischemic heart disease and gangrene. All the patients had some ability to rehabilitate except 3 patients (1 periferal neuropathy, 2 leg amputation).
We should be careful of the unstable hypertension because it often induce the cerebralvascular accident and retinal bleeding. Nineteen patients (30% in all subjects) showed sympton of severe hypotension during dialysis. For the treatment of hypotension, bicarbonate dialysis and high Na dialysis were effectively practiced.
