The Japanese Journal of Clinical Dialysis Vol.16 No.1(3-2)

Theme The Choice of Blood Purification for the Patients with Renal Failure
Title Dialysis for metabolic disease
Publish Date 2000/01
Author Satoru Namie Department of Internal Medicine, Sasebo General Hospital
[ Summary ] End-stage renal disease (ESRD) patients due to metabolic disesae, such as diabetes mellitus, extra-renal disorder complications. It is known that the extra-renal complications of diabetes mellitus are retinopathy, neuropathy and atherosclerotic diseases. The prognosis for dialysis patients with diabetes is worse than that for those having chronic glomerulonephritis. Hemodialiysis and CAPD are common therapies for diabetic patients, and hemodiafiltration or the combination of HD and ECUM are used because of hypotension, due to ultrafiltration, in some patients. Heart failure and cerebrovascular disease are major causes of death in diabetic patients undergoing maintenance dialysis. The prevention of and therapy for these complications is important to produce a better prognosis for these patients. Patients with metabolic diseases, such as amyloidosis, glycogen storage disease or primary hyperoxaluria, have complications associated with extra-renal disorders. It is diffcult to maintain good metabolic condition in these dialvsis patients, and their prognosis is poor because of exta-renal complications. We hope that new methods or devices for dialysis will be developed and will improve the prognosis and quality of life for patients with metabolic diseases who are on dialysis.
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