Renal dialysis: a comparative assessment between diabetic and non-diabetic patients (Alsace, 2002)

Aims: 1/ To determine and compare the different characteristics and methods of extra-renal dialysis in dialyzed diabetic and non-diabetic patients in Alsace and 2/ to compare the differences in referral to a nephrologist in these same two populations before terminal renal failure required renal dialysis. Method: We performed a survey on the prevalence of adults who underwent dialysis in April 2002 in order to determine the associated disorders they had and how they were being treated. In addition, we studied the follow-up which had been given to patients undergoing dialysis for less than one year, before dialysis was required. Results: Among the 810 dialysis patients studied, 28.5 % (± 3.1) were diabetics (D + ). The average age of D + patients (66.3 years ± 1.5) was greater than the average age (60.2 years ± 1.3) of non-diabetic patients (D – ). There was no difference in past history of cerebro-vascular accidents, carotid-artery surgery or vascular access in the two groups. D + patients were more frequently treated with continuous, out-patient peritoneal dialysis (p < 10 –3 ). The follow-up before dialysis was comparable between the D + and D – patients: less than half of them had been followed for more than one year. One-half of both diabetic and non-diabetic patients were first referred to a nephrologist when they were in a severe stage of renal failure. Conclusion: D + patients were more frequently treated with continuous, out-patient peritoneal dialysis than hemodialysis. They did not receive earlier follow-up than D – patients before dialysis was required. This suggests that earlier referral to a nephrologist is needed.