[Treatment of kidney failure in diabetics]

Diabetes mellitus is the only cause of end stage renal disease that is increasing. During a 13-year period 156 diabetics were treated by dialysis and/or renal transplantation. The overall survival rate was 50% at 4 years. Survival was not influenced by the dialysis technique (hemodialysis or peritoneal dialysis) but by age and period of treatment. The main cause of death remained cardiovascular. Adequate medical care, including good control of blood glucose levels and control of high blood pressure, should reduce the frequency of severe complications, especially ocular and peripheral vascular lesions. In diabetics under the age of 50, renal transplantation using a kidney from a cadaver or a related donor should be the first choice. However, for most patients dialysis is required as the only treatment or while awaiting transplantation. When home dialysis is suitable peritoneal dialysis should be preferred. If not, hemodialysis in a dialysis center should be considered.