Diabetes y hemodiálisis. Caracterización de una cohorte y seguimiento a cuatro años

Abstract

Despite a better management of the variables that influence the development of diabetic nephropathy, there is a progressive increase in the prevalence of terminal renal failure among diabetics, whose cause is not clear. Aim: To study, in a group of patients in hemodialysis, the quality of diabetes control previous to the entry to dialysis, their physical condition and their evolution. Material and methods: Diabetic patients with at least three months of hemodialysis answered a questionnaire about diabetes control quality previous to dialysis and had physical and laboratory assessment. They were followed for at least four years thereafter. Results: Fifty seven patients aged 62±11 years were studied. Eighty four percent had some degree of disability. Eighty seven percent had high blood pressure and 73% had to enter dialysis as an emergency. Mean glycosilated hemoglobin was 7.7% and 58% had a dialysis dose with a Kt/V of less than 1.2. Fifty eight percent died during follow up. No relationship between mortality and age, blood pressure, glycosilated hemoglobin of Kt/V, was observed. Conclusions: There is an inadequate management of blood glucose and blood pressure of diabetic patients before entry to dialysis. They are referred late to the nephrologist, the dialysis dose is insufficient and they have a high mortality