Hu Yao-Hua, Liu Ya-Li, Meng Ling-Fei, Zhang Yi-Xian, Cui Wen-Peng
Department of Nephrology, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China.
World J Diabetes. 2024 Sep 15;15(9):1862-1873. doi: 10.4239/wjd.v15.i9.1862.
The increasing prevalence of diabetes has led to a growing population of end-stage kidney disease (ESKD) patients with diabetes. Currently, kidney transplantation is the best treatment option for ESKD patients; however, it is limited by the lack of donors. Therefore, dialysis has become the standard treatment for ESKD patients. However, the optimal dialysis method for diabetic ESKD patients remains controversial. ESKD patients with diabetes often present with complex conditions and numerous complications. Furthermore, these patients face a high risk of infection and technical failure, are more susceptible to malnutrition, have difficulty establishing vascular access, and experience more frequent blood sugar fluctuations than the general population. Therefore, this article reviews nine critical aspects: Survival rate, glucose metabolism disorder, infectious complications, cardiovascular events, residual renal function, quality of life, economic benefits, malnutrition, and volume load. This study aims to assist clinicians in selecting individualized treatment methods by comparing the advantages and disadvantages of hemodialysis and peritoneal dialysis, thereby improving patients' quality of life and survival rates.
糖尿病患病率的不断上升导致患有糖尿病的终末期肾病（ESKD）患者群体日益壮大。目前，肾移植是ESKD患者的最佳治疗选择；然而，它受到供体短缺的限制。因此，透析已成为ESKD患者的标准治疗方法。然而，糖尿病ESKD患者的最佳透析方式仍存在争议。糖尿病ESKD患者往往病情复杂且并发症众多。此外，这些患者面临感染和技术失败的高风险，更容易出现营养不良，建立血管通路困难，并且血糖波动比普通人群更频繁。因此，本文综述了九个关键方面：生存率、糖代谢紊乱、感染性并发症、心血管事件、残余肾功能、生活质量、经济效益、营养不良和容量负荷。本研究旨在通过比较血液透析和腹膜透析的优缺点，协助临床医生选择个体化的治疗方法，从而提高患者的生活质量和生存率。
