抄録
The purpose of this study is to retrospectively analyze the clinical characteristics in patients with diabetes mellitus that were introduced to dialysis therapy. First, we reviewed 120 cases of end-stage renal failure due to diabetic nephropathy that were introduced to dialysis therapy in 1996 and 1997. Presenting features were as follows: men, 62.5%; mean age at introduction, 57±1 years; and mean serum creatinine level, 7.3±0.2 mg/dl. To find any clinical characteristics in the population, we divided patients to 3 groups according to age-younger (below 40 years old:12 patients), senior (more than 65 years: 32 patients) and middle: 76 patients-. In younger age group, average aged of 36±1 years old had lower serum creatinine levels (6.1±0.4 mg/dl) (p<0.05) and greater cardio-thoracic ratio (61.1±1.3 %) (p<0.05) obtained from the chest x-ray film than other two groups. There were no significant differences between the middle aged (59±1 years old) and the senior aged group (72±1 years old) in the levels of serum creatinine and cardio-thoracic ratio. To further analyze the clinical characteristics in the rest of groups, the other 113 patients in 1998 and 1999 who were matched with middle age group in the former study, were retrospectively analyzed. The average was 61±2 years old, and men 54%(62/113). The %changes in body weight were as follows: 9.5±2.8% (p<0.05) from teens to 20s and 19.2±3.2% (p<0.05) from teens to 30s in men. Compared to these changes, the %changes in body weight in women were as follows: 9.6±2.1% (p<0.05) from teens to 30s and 18.6±2.4% (p<0.05) from teens to 40s. The ages of the start of dialysis therapy were 54±2 years old in men and 59±3 years old in women and there was a significant difference (p<0.05). In summary, it is suggested that young patients with diabetic nephropathy received dialysis therapy because of hypervolemic symptoms compared to elder patients, and the renal deterioration progressed more rapidly in male than in female diabetic nephropathy as other renal diseases. From these data, in clinical practice these differences should be borne in mind.
