Retrospective analysis of hemodialyzed diabetic patients in Japan.
We retrospectively analyzed the courses of 37 non-insulin dependent diabetics (hemodialyzed:HD group) with end-stage renal disease (ESRD), to identify factors predisposing to renal failure. The factors analyzed were: diabetic (non-proliferative and proliferative) retinopathy, family histories of diabetes and hypertension, smoking, dyslipidemia, first examination proteinuria and non-compliance. These factors were statistically compared in 37 NIDDM without renal failure (non-HD group). There were no significant differences in age or duration of diabetes between the two groups. Significant differences (P < 0.001) were, however, recognized in diabetic proliferative retinopathy and hypertension between the two groups. Hypertension was present in 35/36 (97.2%) HD patients and in 21/36 (58.3%) non-HD patients. A family history of hypertension was recognized in 16/37 HD (43.2%) and in 7/33 (21.2%) non-HD (P < 0.05). Differences were recognized in HDL-cholesterol, LDL-cholesterol and TG levels (38.2 +/- 12.5 mg/dl and 56.7 +/- 18.5 mg/dl, 140.4 +/- 57.1 mg/dl and 115.6 +/- 33.6 mg/dl, 169.9 +/- 89.4 mg/dl and 115.7 +/- 75.1 mg/dl, in HD and non-HD, respectively, P < 0.05). First visit proteinuria was found in all HD patients, and in 6/34 (17.6%) non-HD. The difference in previous treatment refusal, for 7 or more years, was significant with 23/36 (58.9%) HD patients and only 1/25 (4.0%) non-HD patients (P < 0.001) having a history of prolonged non-compliance with diabetic treatment. Diabetic retinopathy, non-proliferative and proliferative, hypertension and a family history of hypertension, elevated triglyceride and LDL-cholesterol, low HDL-cholesterol, first visit proteinuria, and prolonged non-compliance correlated with progression to ESRD. We advocate expanding diabetic education to include prevention of complications such as diabetic nephropathy.
Takei
I
I
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Yamauchi
A
A
Nakamoto
S
S
Suzuki
H
H
Saruta
T
T
D000368:Aged; D000419:Albuminuria / Q000209:etiology; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D003928:Diabetic Nephropathies / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007564:Japan / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D001786:Blood Glucose; D008055:Lipids