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A study on the prognosis of diabetics undergoing chronic dialysis with a special reference to the long term morbidity and mortality in dialysis



A study on the prognosis of diabetics undergoing chronic dialysis with a special reference to the long term morbidity and mortality in dialysis



Tokyo Jikeikai Medical Journal 102(1): 61-88



Cumulative survival rates (CSR) were studied in seventy-six diabetics with end-stage renal disease from a clinical aspect at the initiation of dialysis. The study period was from January 1978 to June 1985 at the Jikei University Hospital. Overall CSR was 75.7% after one year of dialysis treatment, 53.1% after two years and 41.6% after five years. CSR of continuous ambulatory peritoneal dialysis (CAPD) showed the highest value of 90.7% after one year. Two years after the initiation of dialysis, hemodialysis (HD) achieved a better CSR of 68.9%, and 56.4%, after five years as compared with those of CAPD. Dialysis therapy did not affect long-term outcome of morbidity in CAPD patients. On the contrary, in HD patients significant differences were found in elderly patients (p < 0.01), the presence of ischemic heart disease (p < 0.05) and malnutrition (p < 0.05). Thirty-three out of seventy-six (43.4%) patients died during the study period. Major causes of death were the presence of malnutrition (27%) and heart disease (33.3%). From this clinical analysis, it was postulated that prevention of malnutrition and heart disease seemed most important in order to improve the prognosis of diabetics undergoing chronic dialysis.

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Accession: 004636413

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