Management of Diabetic End-Stage Renal Disease With Dialysis

  • Ploumis S. Passadakis
  • Dimitrios G. Oreopoulos
Part of the Contemporary Diabetes book series (CDI)


The management of diabetic patients with end-stage renal disease (ESRD) by either dialysis treatment (peritoneal dialysis [PD] or hemodialysis [HD]) is more complicated than in nondiabetic patients, mainly because of the presence of advanced comorbid conditions associated with the long-term course of diabetes. During the last two decades, improvements in dialysis modalities resulted in longer survival rates in diabetic patients. HD is the most commonly used therapy, whereas the role of PD in renal replacement therapy (RRT) in patients with diabetic nephropathy (DN) is well established. The decision regarding the choice for treatment options (PD vs HD) must be individualized as survival and rehabilitation data among the two modalities are comparable, at least for the first 5 yr after initiation. However, the best outcome of diabetic ESRD patients may be obtained by integrated care, starting with PD and switching to HD if problems arise, and keeping suitable patients on the renal or renal-pancreas transplantation waiting list.


Diabetic Patient Peritoneal Dialysis Renal Replacement Therapy ESRD Patient Continuous Ambulatory Peritoneal Dialysis 
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Copyright information

© Humana Press Inc., Totowa, NJ 2006

Authors and Affiliations

  • Ploumis S. Passadakis
    • 1
  • Dimitrios G. Oreopoulos
    • 1
  1. 1.The Toronto Hospital WesternToronto, OntarioJapan

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