Abstract
Abstract Diabetes is the most common cause of new patients requiring renal replacement therapy (RRT), accounting for approximately 45% of cases in the US. Recent population-based study from North India, showed that the most common cause of chronic kidney disease (CKD) was diabetic nephropathy (DN) responsible for 41% of the cases. Many, but not all, nephrologists are of the opinion that RRT should be started earlier in diabetic than in non-diabetic patients, i.e. at an estimated glomerular filtration rate (eGFR) of approximately 15 mL/min. Hemodialysis (HD) is still the most common RRT modality in patients with diabetes. Failure of vascular access, intradialytic hypotension, high-risk of cardiovascular disease, retinopathy, amputation, and malnutrition are some common problems occurring among diabetic end-stage renal disease (ESRD) patients. Patient survival in diabetics on maintenance dialysis is lower than that seen in non-diabetics with end-stage renal failure due to chronic glomerular disease or hypertension cardiovascular disease is the most common cause of death, accounting for more than one-half of cases.
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