RT Journal Article
T1 Management of Kidney Failure in Patients with Diabetes Mellitus: What Are the Best Options?
A1 Buades, Juan M
A1 Craver, Lourdes
A1 Del Pino, Maria Dolores
A1 Prieto-Velasco, Mario
A1 Ruiz, Juan C
A1 Salgueira, Mercedes
A1 de Sequera, Patricia
A1 Vega, Nicanor
K1 chronic kidney disease
K1 comprehensive conservative care
K1 diabetic kidney disease
K1 hemodialysis
K1 home hemodialysis
K1 kidney failure
K1 kidney replacement therapy
K1 kidney transplant
K1 peritoneal dialysis
AB Diabetic kidney disease (DKD) is the most frequent cause of kidney failure (KF). There are large variations in the incidence rates of kidney replacement therapy (KRT). Late referral to nephrology services has been associated with an increased risk of adverse outcomes. In many countries, when patients reach severely reduced glomerular filtration rate (GFR), they are managed by multidisciplinary teams led by nephrologists. In these clinics, efforts will continue to halt chronic kidney disease (CKD) progression and to prevent cardiovascular mortality and morbidity. In patients with diabetes and severely reduced GFR and KF, treating hyperglycemia is a challenge, since some drugs are contraindicated and most of them require dose adjustments. Even more, a decision-making process will help in deciding whether the patient would prefer comprehensive conservative care or KRT. On many occasions, this decision will be conditioned by diabetes mellitus itself. Effective education should cover the necessary information for the patient and family to answer these questions: 1. Should I go for KRT or not? 2. If the answer is KRT, dialysis and/or transplantation? 3. Dialysis at home or in center? 4. If dialysis at home, peritoneal dialysis or home hemodialysis? 5. If transplantation is desired, discuss the options of whether the donation would be from a living or deceased donor. This review addresses the determinant factors with an impact on DKD, aiming to shed light on the specific needs that arise in the management and recommendations on how to achieve a comprehensive approach to the diabetic patient with chronic kidney disease.
SN 2077-0383
YR 2021
FD 2021-06-30
LK http://hdl.handle.net/10668/18129
UL http://hdl.handle.net/10668/18129
LA en
DS RISalud
RD Apr 9, 2025