| [ Summary ] |
Diabetic nephropathy has become the leading cause of end-stage renal disease (ESRD) in incident patients also in Japan. Therapeutic modality for diabetic ESRD consists of hemodialysis, continuous ambulatory peritoneal dialysis (CAPD) and kidney transplantation. However, as few patients can receive kidney transplantats in Japan, the vast majority of diabetic patients selects one of the two dialytic therapies. Modality selection should be made on the basis of each patient's clinical symptoms and activity of daily living. Using an ultraviolet CAPD exchange system, the incidence of peritonitis in diabetic patients was less than that in non-diabetic patients. Fair to good glycemic control can be achieved by using adequate dose of insulin. CAPD appeared advantageous in terms of stabilizing diabetic retinopathy compared to hemodialysis. Because CAPD in diabetic patients is associated with hypercoagulability, the effect of this modality on cardiovascular disease should be determined. |