Clinical study of complications in dialyzed diabetics

The authors retrospectively investigated 62 diabetics who had received dialytic therapy at our department and our associated hospital over the past 10 years. We studied the complications and causes of death among the 62 subjects. Of the 62 patients (male 42, female 20), 27 (male 21, female 6), had died. The causes of death in the 27 cases included 7 from general weakness, 4 from gastrointestinal bleeding, 4 from cerebrovascular hemorrhage or thrombosis, 3 suicide, 3 congestive heart failure, 2 myocardial infarction, 2 hyperkalemia, 1 infection and 1 from hepatoma. With regard to diabetic retinopathy, 19 of the 62 patients suffered from bilateral blindness and 12 from unilateral blindness. In 8 patients, visual complications developed after hemodialysis, but 16 patients were already blind at the introduction of hemodialysis. There was no evidence that retinopathy was accelerated by dialysis and the authors suggest that the treatment of retinopathy is very important at the nondialyzed stage. With regard to other complications in dialyzed diabetics, unstable hypertension, diabetic gastroenteropathy, peripheral neuropathy, ischemic heart disease and gangrene were discovered in our population. Some rehabilitation was possible in all but 3 of the subjects (1 peripheral neuropathy, 2 leg amputation).