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Titolo:
Attaining long-term survival when treating diabetic patients with ESRD by hemodialysis
Autore:
Bommer, J;
Indirizzi:
Univ Heidelberg, Med Klin, Sekt Nephrol, D-69115 Heidelberg, Germany Univ Heidelberg Heidelberg Germany D-69115 , D-69115 Heidelberg, Germany
Titolo Testata:
ADVANCES IN RENAL REPLACEMENT THERAPY
fascicolo: 1, volume: 8, anno: 2001,
pagine: 13 - 21
SICI:
1073-4449(200101)8:1<13:ALSWTD>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
STAGE RENAL-DISEASE; AMBULATORY PERITONEAL-DIALYSIS; VASCULAR ACCESS; NEPHROPATHY; MORTALITY; THERAPY; BYPASS; RISK; PREDICTORS; PROGNOSIS;
Keywords:
hemodialysis; diabetes mellitus; survival; ESRD;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Bommer, J Univ Heidelberg, Med Klin, Sekt Nephrol, Bergheimer Str 58, D-69115 Heidelberg, Germany Univ Heidelberg Bergheimer Str 58 Heidelberg Germany D-69115 ny
Citazione:
J. Bommer, "Attaining long-term survival when treating diabetic patients with ESRD by hemodialysis", ADV RENAL R, 8(1), 2001, pp. 13-21

Abstract

Diabetic nephropathy is the most common cause of end-stage renal disease (ESRD). The United States Renal Data System's report indicates that survivalof diabetic patients has improved but continues to be reduced compared with that of nondiabetic patients. Several ways to decrease morbidity and mortality in diabetic patients are discussed: (1) Instructions and treatment inthe predialysis period markedly influence compliance of patients, and thisplays a determinant role in development and progression of diabetic complications before and during maintenance hemodialysis. (2) After the start of hemodialysis therapy, insulin therapy must be adjusted and respect impairedglucose use and prolongation of insulin half-life. (3) By avoiding of puncture of veins prospectively used for arteriovenous fistulae and timely installation of the fistulae, native arteriovenous fistulae can be achieved in more than 70% of diabetic patients. (4) Hypertension, left ventricular hypertrophy, and cardiovascular problems commonly found in diabetic patients require optimal removal of fluid overload. This is difficult to achieve in the presence of accelerated arteriosclerosis and autonomic polyneuropathy in diabetic patients and requires long and smooth dialysis procedures. (5) Infected necroses caused by diabetic polyneuropathy and peripheral vascular disease require appropriate therapy by experienced nephrologists and surgeons. (C) 2001 by the National Kidney Foundation, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/10/20 alle ore 05:48:19