Neuropathy and quality of life in diabetic continuous ambulatory peritoneal dialysis patients

Diabetes mellitus is the commonest cause of end-stage renal failure and is associated with considerable morbidity. Neuropathy is one of the most serio us complications of diabetes, linked to the incidence of nephropathy and re tinopathy. The prevalence of neuropathy increases with age and duration of diabetes. Peripheral sensorimotor neuropathy is the main manifestation of n eurological damage in diabetes, while autonomic neuropathy, a devastating c omplication, is also present in a large number of patients with long-term d iabetes. Clinical features of autonomic neuropathy are mainly cardiovascula r disorders and abnormal visceral function. One of the most important seque lae of neuropathy is the development of the insensitive foot at risk of ulc eration, deformation, Charcot neuroarthropathy, and amputation. Prevention, education, and identification of the at-risk patient are the key elements in managing these severe complications. Dialysis, and mainly peritoneal dia lysis, still remains the main renal replacement therapy for end-stage renal disease (ESRD) diabetic patients. It is obvious from many studies that dia betes and its complications are major risk factors associated with poorer s urvival rates, increased morbidity, and decreased quality of life. Few, if any, data are available specifically evaluating quality of life in continuo us ambulatory peritoneal dialysis (CAPD) diabetic patients. Fewer data are available estimating the impact of neuropathy on the quality of life of suc h patients. Specific studies must be carried out to further investigate qua lity-of-life issues and neuropathy in this vulnerable group of patients.