title: Renal replacement therapy in diabetic nephropathy.
abstract: The case of a patient with diabetes mellitus and renal failure is presented and discussed. This case represents the very successful course of a diabetic patient who received peritoneal dialysis for 14 years. Not all patients with end-stage renal disease (ESRD) from diabetic nephropathy are this fortunate. The success and complications of dialytic modalities are discussed by a nephrologist and nurse dialysis coordinator. Renal transplantation, the preferred treatment for most diabetic ESRD patients, is discussed by a nurse transplant coordinator. Simultaneous pancreas kidney transplantation, with its potential benefits in the future is discussed by an experienced transplant surgeon. In addition, the psychosocial issues of renal failure, dialysis, and transplantation in the diabetic patient are addressed by clinical social workers. Lastly, the very important issue of foot care and treatment, and prevention of vascular-related morbidity is discussed by a practicing podiatrist. With such a multidisciplinary approach, medical and psychosocial outcomes can be optimized for diabetic patients with renal failure.
authors.affiliation: Department of Medicine, University of Wisconsin Medical School, Madison, USA.
authors.forename: S W
authors.initials: SW
authors.lastname: Zimmerman
authors.forename: H
authors.initials: H
authors.lastname: Sollinger
authors.forename: M
authors.initials: M
authors.lastname: Wakeen
authors.forename: M
authors.initials: M
authors.lastname: Armbrust
authors.forename: D
authors.initials: D
authors.lastname: Cole
authors.forename: M E
authors.initials: ME
authors.lastname: Kearney
authors.forename: A
authors.initials: A
authors.lastname: Kalker
mesh_terms: D000223:Adaptation, Psychological; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000523:psychology / Q000628:therapy; D017719:Diabetic Foot / Q000628:therapy; D003928:Diabetic Nephropathies / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010531:Peritoneal Dialysis, Continuous Ambulatory; D051437:Renal Insufficiency / Q000209:etiology / Q000523:psychology / Q000628:therapy*
chemical_list: D007328:Insulin