Treatment targets for diabetic patients on peritoneal dialysis: any evidence?
Diabetic patients are often affected by comorbid conditions that influence clinical outcome. Taking care of diabetic peritoneal dialysis (PD) patients is a challenge for nephrologists, not only because these patients have more complications and comorbidities, but also because of their difficulties in maintaining glycemic control with the use of current glucose-containing dialysis solutions. In addition, the increased transport of small molecules and proteins by the peritoneal membrane in diabetic patients adds the further problems of ultrafiltration deficit and malnutrition. The present article reviews pertinent evidence toward establishing the best strategy for the care of diabetic PD patients. With better glycemic control, improved nutrition, improved fluid balance, and optimal preservation of residual renal function, there is hope for improving the survival of diabetic PD patients.
Huang
Chiu-Ching
CC
Division of Nephrology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan. cch@www.cmuh.org.tw
D001786:Blood Glucose / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D015314:Dialysis Solutions / Q000737:chemistry; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008991:Monitoring, Physiologic; D010530:Peritoneal Dialysis; D011379:Prognosis; D015996:Survival Rate
D001786:Blood Glucose; D015314:Dialysis Solutions