Totten M A, Izenstein B, Gleason R E, Takacs F J, Libertino J A, D'Elia J A
J Dial. 1978;2(1):17-32. doi: 10.3109/08860227809103861.
Clinical observations for 49 diabetic patients who required chronic hemodialysis or renal transplantation during a four year period are presented. Twenty-seven dialysis patients had a two year cumulative survival of 74% compared to 54% for 22 transplantation patients. The cumulative survival of live-related donor recipients (77%) was similar to that of the dialysis group and significantly better than that of cadaveric allograft recipients (36%). While the incidences of cardiomegaly and of motor neuropathy were high among live-related donor recipients, dialysis patients more often demonstrated peripheral vascular disease. Causes of death in hemodialysis patients included cardipulmonary arrest and patient decision to discontinue therapy; in the transplantation group included cardiopulmonary arrest, sepsis, and stroke. Living-related transplantation remains the preferred mode of therapy because of the potential for rehabilitation. In terms of patient survival, the risks of cadaver transplantation must be weighted against the discomforts of chronic dialysis.
本文介绍了49例糖尿病患者在四年期间需要进行慢性血液透析或肾移植的临床观察结果。27例透析患者的两年累积生存率为74%，而22例移植患者为54%。活体亲属供肾受者的累积生存率（77%）与透析组相似，且显著高于尸体同种异体肾移植受者（36%）。虽然活体亲属供肾受者中心脏扩大和运动神经病变的发生率较高，但透析患者外周血管疾病更为常见。血液透析患者的死亡原因包括心肺骤停和患者决定停止治疗；移植组的死亡原因包括心肺骤停、败血症和中风。由于具有康复潜力，活体亲属肾移植仍然是首选的治疗方式。就患者生存率而言，尸体肾移植的风险必须与慢性透析的不适相权衡。
