[Survival of dialyzed diabetic patients]

Diabetes is a cause of end-stage renal failure of increasing importance. Our aim was to evaluate the survival of diabetic and non-diabetic patients on dialysis treatment.

Two hundred and ninety-five patients on dialysis program in a tertiary referral center of the São Paulo city, from 1992-94, were studied. Seventy-one patients were diabetics (17 type I and 54 type II) and 224 had other diagnoses of renal disease. Data were prospectively collected using standard questionnaires and also retrospectively for patients who started treatment between 1992 and June 1993. Survival analysis was done using the product-limit method.

Diabetic patients had a greater mean age and a higher proportion on peritoneal dialysis than non-diabetics. After one year, survival rates were 67% and 86% for diabetics and non-diabetics (p < 0.0001). The difference in survival rates increased with the duration of treatment. This difference was observed both in young (< or = 50 years) and in elderly patients, although it has been noted earlier in the former. Survival of diabetics remained significantly reduced adjusting for the age of the patients.

Diabetic patients on dialysis have lower survival rates than non-diabetics, independently of their greater mean age. Special attention should be given to these patients, both in relation to pre-dialysis comorbidity and during dialysis treatment, to improve their survival experience.