The Japanese Journal of Clinical Dialysis Vol.22 No.4(10)

Theme Cardiovascular Complications in Chronic Dialysis Patients -- Are They Inevitable?
Title Cardiovascular disease in diabetic patients with chronic renal failure
Publish Date 2006/04
Author Tetsuo Shoji Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine
Author Yoshiki Nishizawa Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine
[ Summary ] The characteristics of vascular disease in diabetic hemodialysis patients include a high prevalence of advanced arterial changes without typical symptomatic manifestations. Coronary angiographical studies reveal multi-vessel disease, with calcification, involving more distal regions. Foot ulcers are also more prevalent in hemodialysis patients with diabetes mellitus, and these patients are at an increased risk of amputation and death. The increased risk of mortality from cardiovascular disease is explained by the increased event occurrence and the increased fatality rates after an event. In addition to advanced arterial thickening, stiffening, and calcification, the high cardiovascular mortality rates in diabetic patients with renal failure may be attributable to other factors such as diabetic retinopathy, neuropathy, immune dysfunction, in addition to nutritional problems associated with diabetes mellitus.
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