Clinical observation of diabetic patients undergoing hemodialysis for more than 10 years

Abstract

Clinical observation of diabetic patients undergoing hemodialysis for more than 10 years in 68 dialysis units in Hyogo prefecture were surveyed using a questionnaire form. Total cases were 30 patients (male: 16, female: 14). The mean age was 62.5±8.0 (SD) years old and the mean duration of dialysis was 15±4.3 (SD) years. As control subjects, 30 non diabetic uremic patients (age and dialysis-history matched) were randomly selected. Blood pressure, fasting blood glucose, and HbA_1C of diabetic uremic subjects were relatively good. General nutritional status was good and anemia was relatively well controlled. The serum level of intact PTH in diabetic subjects was relatively high compared to the reference level and was slightly less compared with that of the non diabetic control, although this difference was not significant. There were only four cases of parathyroidectomy and 9 cases of carpal tunnel syndrome. Among these, 7 cases underwent surgery. Destructive spondylopathy was recognized in two cases. Macrovascular lesions were prevalent in the diabetic group. Occlusion of the lower limb, cardiovascular damage, cerebrovascular accident and history of ischemic heart disease were highly recognized compared with the non diabetic control. Diabetic retinopathy was recognized in all cases, but only 2 cases were blind. The present study shows the treatment of diabetic uremic patients undergoing long-term hemodialysis has remarkably improved in recent years.