Dialysis and Transplantation of Diabetics in the United States

Abstract

The diabetic with end-stage renal failure (ESRF) due to nodular and diffuse intercapillary glomerulosclerosis faces the same thereapeutic alternatives as does the nondiabetic uremic. Their choices include maintenance hemodialysis (MD), maintenance peritoneal dialysis and renal transplantation. Because of coincident multiple vascular complications the diabetic is subject to high mortility and excessive morbidity. Over the past 7 yr an increasing number of diabetics have been transplanted and begun on dialytic thereapy. Selection of dialysis or transplantation in a specific patient requires knowledge of the relative risks and benefits of each treatment. The reported series of uremic diabetics managed by dialysis and transplantation is reviewed in an effort to facilitate the choice.