[Treatment by continuous ambulatory peritoneal dialysis for chronic renal insufficiency in the diabetic]

The number of diabetics with end stage renal failure is growing. The best treatment at the lowest cost possible should be offered to all diabetics if therapeutics facilities are available. Such a policy requires that all dialysis methods and transplantation should be available and that transfer from one method to another should always be allowable. Results observed among diabetics are improving steadily, even in the older age group. However they are inferior to those observed in non diabetic people of the same age. In diabetic patients under fifty years of age, renal transplantation using a kidney from a cadaver or a related donor should be the first choice. In some cases kidney and pancreas transplantation is possible. However, for most patients dialysis methods are required as the only treatment or while waiting for a transplant. If home dialysis is considered, continuous ambulatory peritoneal dialysis offers the opportunity to treat many insulin or non insulin-dependent diabetics at home even those in the high risk population because of age and/or cardio-vascular instability with excellent control of blood glucose levels, hypertension, vision, residual renal function, despite the peritoneal infections. These results are obtained from data in the literature and the survey of patients treated at the Hospital de la Pitié.