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2012/08/16

Dialysis in Diabetic Nephropathy: Pros and Cons

Cons and Pros for dialysis treatment in Diabetic nephropathy? End-stage diabetic nephropathy patients undergoing have two choices of dialysis: long-term hemodialysis and continuous ambulatory peritoneal dialysis. Recently, the vast majority of patients with end-stage diabetic nephropathy to take peritoneal dialysis, because it does not increase the heart load and stress, better control of extracellular fluid volume and hypertension. Also by intraperitoneal injection of insulin, easy to operate, cost savings, but some patients due to long-term peritoneal dialysis absorb a large number of glucose Erzhi obesity and high cholesterolDiabetic with ESRD, which type of dialysis to choose?Patients with diabetic nephropathy to advanced prone to serious deterioration of renal function, and even uremia. Although dialysis treatment is not advanced diabetic nephropathy in patients with the best treatment, but if early, long-term dialysis treatment can greatly improve the survival rate of patients. When serum creatinine in the 350-440umol / L should be prepared to vascular pathways; when serum creatinine reached 600umol / L or more, you can start dialysis treatment. Clinical in the end is to choose hemodialysis or peritoneal dialysis should be selected according to the disease and the specific conditions.Hemodialysis.In diabetic nephropathy patients on long-term hemodialysis patients, 1-year survival rate of more than 80%. Older, serious condition acceptable to the dialysis treatment. Dialysis in advance, less uremic complications; where the pre-dialysis and dialysis process, better control of blood pressure, attention to fluid balance, to ensure a reasonable nutrition, the survival rate of patients will improve. Hemodialysis process can also be some problems, such as poor vascular pathways, large fluctuations in blood pressure, worsening retinopathy and even blindness and a variety of cardiovascular complications.

[Peritoneal dialysis]1-year survival rate of peritoneal dialysis in diabetic nephropathy was 80% to 90%. Its main advantages are:① cardiovascular system is more stable, better blood pressure control.② to avoid the path of blood vessels.(3) through the abdomen, and injection of insulin, blood sugar control better.The retinopathy can be stable improvement.(5) PD operation is more convenient to patients themselves.⑥ in the high molecular substances cleared.Its shortcomings: 1-prone abdominal infection after infection, easy to shadow noon dialysis effect.The peritoneal dialysis daily loss of protein l0g to pay attention to protein intake.In summary, can not be advanced diabetic nephropathy in kidney transplant ambulatory continuous peritoneal dialysis results better than hemodialysis.  

Considering  peritoneal dialysis, dialysate glucose was partially absorbed by hypertonic dialysate induced hyperosmolar coma, so pay attention to the use of insulin dose adjustment, while avoiding hypoglycemia. However, the possibility of peritonitis in peritoneal dialysis when compared with non-diabetic patients, should pay close attention to actively prevent infection. Dialysis costs are high, the patient's body is even more painful. Is there a treatment more effective and more to reduce the suffering of the patient? 
The answer is yes. after painstaking research, the original micro-based traditional Chinese medicine penetration therapy.
 Related article:
How do Diabetics with High Creatinine Keep away from Dialysis
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