Renal failure secondary to diabetic nephropathy. Review of characteristicsin diabetic patients who started hemodyalisis in Catalonia in 1994

The appearance of diabetic nephropathy and its progression towards renal fa ilure can be prevented if an early treatment is instituted. However, diabet es is currently one of the main causes of entry into a dialysis program. Th erefore, the diagnostic characteristics of renal disease in 105 patients wh o started dialysis in Catalonia in 1994 were reviewed; the presence of othe r changes associated with diabetes were assessed. The results showed that 8 1.7% of patients had proteinuria higher than 0.5 g/24 h, and 40.5% had plas ma creatinine higher than 5 mg/dl at the first nephrological control. As a result, the period between diagnosis of nephropathy and the inclusion in th e dialysis program was very short (3.7 years) and considerably shorter than that reflected in literature for other countries, whereas the incidence of other micro and macrovascular complications was similar. Remarkably, a hig h number of smokers and treatment with oral antidiabetic drugs (33%) at the end stage of renal failure was observed. These results suggest that follow -up of diabetics should be more exhaustive and serial tests be performed to detect nephropathy early. An appropiate control during renal failure stage can also postpone the disease progression and avoid the appearance of comp lications which at present have a high morbi-mortality and high cost.