The Japanese Journal of Clinical Dialysis Vol.17 No.1(2-2-8)

Theme Forefront of Diabetic Nephropathy
Title The complication of diabetic nephropathy : Peripheral vascular disease
Publish Date 2001/01
Author Hiromi Hamada Department of Surgery, Nikko-Medical Hospital
Author George Takada Department of Surgery, Nikko-Medical Hospital
Author Yoshio Katsuki Department of Surgery, Nikko-Medical Hospital
Author Yasushige Tsuji Department of Surgery, Nikko-Medical Hospital
Author Seiji Ohira Department of Surgery, Nikko-Medical Hospital
[ Summary ] Along with the increase in diabetic nephropathy patients undergoing hemodialysis has come an increase in patients with peripheral vascular disease. Diabetic nephropathy patients frequently show chronic multiple stenosis in the crural arteries and below, skin ulcers and necrosis in the limbs. In these cases, preservative therapy has only a temporary effect and many require surgical treatments. Surgical treatments consist primarily of reestablishing blood flow, however, in many cases the required blood flow is not achieved and amputation of the limb becomes necessary. In these cases however, the prognosis is poor. In the case of diabetic nephropathy, arterial sclerosis is a cause of blood access problems and in the construction of blood access, attention should be paid to this. When peripheral vascular disease is discovered in a diabetic nephropathy patient, a vascular surgeon should be consulted early on.
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