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Scherbaum, C. R. and Fischereder, M. (2016): Diabetes und Dialyse. In: Diabetologe, Vol. 12, No. 3: pp. 209-217

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Abstract

In principle, all forms of renal replacement therapy are suitable for patients with end-stage renal disease (ESRD) and diabetes mellitus. The choice of the modality used in an individual patient must be made taking into consideration the patient's preference, preferably in a preterminal phase. If hemo dialysis is expected in the upcoming 6 months, placement of an arteriovenous fistula should performed at that stage to avoid the need for a dialysis catheter. Continuous ambulatory peritoneal dialysis (CAPD) is an alternative for patients with diabetes. While renal transplantation results in superior survival rates, most patients are not good candidates due to comorbidities. For dialysis patients diabetes therapy is limited to insulin and sitagliptin. The goal of treatment is avoiding hypoglycemia and reaching a HbA1c (hemoglobin type A1c) of 7-8% (53-64 mmol/mol). Antihypertensive treatment usually requires combination treatment, often including a beta-blocker.

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