RETROSPECTIVE ANALYSIS OF HEMODIALYZED DIABETIC-PATIENTS IN JAPAN

We retrospectively analyzed the courses of 37 non-insulin dependent di abetics (hemodialyzed:HD group) with endstage renal disease (ESRD), to identify factors predisposing to renal failure. The factors analyzed were: diabetic (nonproliferative and proliferative) retinopathy, famil y histories of diabetes and hypertension, smoking, dyslipidemia, first examination proteinuria and non-compliance. These factors were statis tically compared in 37 NIDDM without renal failure (non-HD group). The re were no significant differences in age or duration of diabetes betw een the two groups. Significant differences (P < 0.001) were, however, recognized in diabetic proliferative retinopathy and hypertension bet ween the two groups. Hypertension was present in 35/36 (97.2%) HD pati ents and in 21/36 (58.3%) non-HD patients. A family history of hyperte nsion was recognized in 16/37 HD (43.2%) and in 7/33 (21.2%) non-HD (P < 0.05). Differences were recognized in HDL-cholesterol, LDL-choleste rol and TG levels (38.2 +/- 12.5 mg/dl and 56.7 +/- 18.5 mg/dl, 140.4 +/- 57.1 mg/dl and 115.6 +/- 33.6 mg/dl, 169.9 +/- 89.4 mg/dl and 115. 7 +/- 75.1 mg/dl, in HD and non-HD, respectively, P < 0.05). First vis it proteinuria was found in all HD patients, and in 6/34 (17.6%) non-H D. The difference in previous treatment refusal, for 7 or more years, was significant with 23/36 (58.9%) HD patients and only 1/25 (4.0%) no n-HD patients (P < 0.001) having a history of prolonged non-compliance with diabetic treatment. Diabetic retinopathy, non-proliferative and proliferative, hypertension and a family history of hypertension, elev ated triglyceride and LDL-cholesterol, low HDL-cholesterol, first visi t proteinuria, and prolonged non-compliance correlated with progressio n to ESRD, We advocate expanding diabetic education to include prevent ion of complications such as diabetic nephropathy.