Abstract
Diabetic nephropathy is the second most frequent underlying disease among patients on hemodialysis. In order to elucidate the deleterious factors affecting the decline in renal function in diabetic nephropathy, and to clarify the beneficial effects of dietary treatment, retrospective analysis was done using Δ1/creatinine regression analysis. It was revealed that the amount of urinary protein has a deleterious effect on the deterioration of renal function, while a protein-restricted diet has a favorable effect. Also, it was considered that diabetic nephropathy has a heterogeneous character, and that aged patients who show low-grade proteinuria, mild ocular lesions and have not undergone insulin treatment have lesions of a nephrosclerotic rather than a diabetic nephropathic character. The improvement of overhydration by hemodialysis treatment induced aggravation of diabetic control. Therefore anasarca is considered to contribute to the amelioration of diabetic status, which is frequently observed at the end-stage of renal failure.
