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Titolo:
Incidence and clinical presentation of terminal renal failure in diabetic patients
Autore:
Schwenger, V; Mussig, C; Hergesell, O; Zeier, M; Ritz, E;
Indirizzi:
Univ Heidelberg, Med Klin, Sekt Nephrol, D-69115 Heidelberg, Germany Univ Heidelberg Heidelberg Germany D-69115 , D-69115 Heidelberg, Germany
Titolo Testata:
DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT
fascicolo: 47, volume: 126, anno: 2001,
pagine: 1322 - 1326
Fonte:
ISI
Lingua:
GER
Soggetto:
RISING TIDE; NEPHROPATHY; MELLITUS; PATTERNS; KIDNEY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Schwenger, V Univ Heidelberg, Med Klin, Sekt Nephrol, Bergheimer Str 58, D-69115 Heidelberg, Germany Univ Heidelberg Bergheimer Str 58 Heidelberg Germany D-69115
Citazione:
V. Schwenger et al., "Incidence and clinical presentation of terminal renal failure in diabetic patients", DEUT MED WO, 126(47), 2001, pp. 1322-1326

Abstract

Background: In all Western countries there is a dramatic increase of diabetic patients who need renal replacement therapy. Very different figures forincidence and prevalence have been reported. There is a strong suspicion that the epidemiological dimension of the problem has been underestimated inmany of the statistics. Methods: In a retrospective analysis we assessed all patients admitted to the Department Internal Medicine Heidelberg from January 1(st) 1998 - December 31(st), 2000 for renal replacement therapy, i.e. hemodialysis or CAPD, because of acute or chronic renal failure. We counted the number of known diabetic patients (i) with signs of classical diabetic nephropathy (enlargedkidneys, proteinuria > 1 g/24h +/- retinopathy), (ii) with atypical renal changes (contracted kidneys, proteinuria < 1 g/24 h) and (iii) diabetic patients with (coincident) primary chronic renal disease as well as (iv) the proportion of patients in whom the diagnosis of diabetes had been unknown when uremia had supervened. Results: Dialysis treatment was started in 568 patients for acute (ARF; n = 341) or chronic (CRF; n = 227) renal failure. 95/341 (28%) patients with ARF had diabetes. ARF occured in no less than 12/95 (13%) of the diabetic patients after cardiological intervention. Diabetes was present in 111/227 patients with CRF (7 type 1, 104 type 2); in 12/111 patients the diagnosis of diabetes was established only after admission. Only 67/111 of the diabetic patients (60%) had classical signs of diabetic nephropathy, in 14/111 (13%) patients the classical signs of diabetic nephropathy were absent and in 30/111 (27%) non-diabetic primary chronic renal disease was present. Conclusion: The study illustrates the importance of diabetes for the epidemiology of renal failure. A sizeable proportion of patients with acute renal failure have diabetes, typically patients with pre-existing nephropathy in whom this complication supervenes during diagnosis and treatment of late diabetic complications. In diabetic patients with chronic renal failure thepresentation is frequently atypical and non-diabetic primary renal diseaseis present more frequently than expected by chance. In a sizeable proportion of patients diabetes had not been diagnosed by the time chronic renal failure occurred.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 06:36:38