[Treatment of chronic kidney failure in diabetics with peritoneal dialysis]

The number of dialyzed diabetics in this country is increasing (14.5% of all dialyzed patients in 1993). Haemodialyzation treatment of diabetics has, however, some pitfalls: it is difficult to create a permanent vascular approach, the risk of intraocular haemorrhage during heparinization etc. Therefore some authors prefer peritoneal dialysis in the case of renal failure in diabetics. The technique of insertion of an intraperitoneal catheter and treatment proper are in principle the same as in non-diabetic subjects; the method does not require a vascular approach and heparin is not administered. Other advantages of peritoneal dialysis are the stability of the milieu intérieur, the preserved residual renal function and the possibility of intraperitoneal insulin administration which imitates the physiological release from the pancreas. Peritoneal dialysis has, however, also some disadvantages: the main risk is peritonitis. It can hasten atherosclerosis, malnutrition is relatively frequent etc. The main value of peritoneal dialysis is extension of therapeutic possibilities for diabetics with renal failure.