Polla-Imhoof B, Pirson Y, Lafontaine J J, Vandenbroucke J M, Cosyns J P, Squifflet J P, Alexandre G P, Van Ypersele de Strihou C
Nephrologie. 1982;3(2):80-4.
The respective merits of hemodialysis (HD) and transplantation (TP) in the treatment of 25 patients with diabetic renal failure are analyzed. Overall patient survival whatever the method of treatment is 72% at one year and 50% at 4 years. One year survival is 67% for patients treated only by HD and 81% after TP. This difference results in part from the fact that early death after the initiation of therapy occurs usually during HD prior to TP. Death results mainly from cardiovascular disease (6/7 deaths) in HD and from infectious complications (5/9 deaths) after TP. Taken together with death, rejection of 11/19 grafts reduces graft survival to 56% at one year and 33% at 2 years. Progression of cardiovascular, ocular and neurologic complications is similar whatever the mode of treatment. Recurrence of diabetic renal disease was documented in the graft of one patient. All patients with a 2 year survival (6 grafted, 1 dialyzed) have an excellent rehabilitation. Altogether both methods of treatment appear satisfactory. The initial pessimism regarding the outcome of HD treatment appears unwarranted. Unfortunately, both HD and TP remain marred by a greater number of complications in diabetic than in non-diabetic patients. Initiation of therapy at an earlier stage of the disease and better control of the diabetes might further improve results.
分析了血液透析（HD）和移植（TP）治疗25例糖尿病肾衰竭患者的各自优点。无论采用何种治疗方法，患者1年的总体生存率为72%，4年为50%。仅接受HD治疗的患者1年生存率为67%，TP治疗后为81%。这种差异部分是由于治疗开始后的早期死亡通常发生在TP之前的HD期间。HD死亡主要源于心血管疾病（6/7例死亡），TP后主要源于感染并发症（5/9例死亡）。加上死亡情况，11/19例移植物发生排斥反应，使移植物1年生存率降至56%，2年降至33%。无论采用何种治疗方式，心血管、眼部和神经并发症的进展情况相似。1例患者的移植物中记录到糖尿病肾病复发。所有存活2年的患者（6例接受移植，1例接受透析）康复情况良好。总体而言，两种治疗方法似乎都令人满意。最初对HD治疗结果的悲观态度似乎没有根据。不幸的是，与非糖尿病患者相比，HD和TP在糖尿病患者中仍存在更多并发症。在疾病的早期阶段开始治疗并更好地控制糖尿病可能会进一步改善治疗效果。
