Zimmerman S W, Sollinger H, Wakeen M, Armbrust M, Cole D, Kearney M E, Kalker A
Department of Medicine, University of Wisconsin Medical School, Madison, USA.
Adv Ren Replace Ther. 1994 Apr;1(1):66-74. doi: 10.1016/s1073-4449(12)80023-9.
The case of a patient with diabetes mellitus and renal failure is presented and discussed. This case represents the very successful course of a diabetic patient who received peritoneal dialysis for 14 years. Not all patients with end-stage renal disease (ESRD) from diabetic nephropathy are this fortunate. The success and complications of dialytic modalities are discussed by a nephrologist and nurse dialysis coordinator. Renal transplantation, the preferred treatment for most diabetic ESRD patients, is discussed by a nurse transplant coordinator. Simultaneous pancreas kidney transplantation, with its potential benefits in the future is discussed by an experienced transplant surgeon. In addition, the psychosocial issues of renal failure, dialysis, and transplantation in the diabetic patient are addressed by clinical social workers. Lastly, the very important issue of foot care and treatment, and prevention of vascular-related morbidity is discussed by a practicing podiatrist. With such a multidisciplinary approach, medical and psychosocial outcomes can be optimized for diabetic patients with renal failure.
本文介绍并讨论了一例糖尿病合并肾衰竭患者的病例。该病例代表了一名接受腹膜透析14年的糖尿病患者非常成功的治疗过程。并非所有糖尿病肾病所致终末期肾病（ESRD）患者都如此幸运。一位肾病学家和护士透析协调员讨论了透析方式的成功与并发症。一位护士移植协调员讨论了肾移植，这是大多数糖尿病ESRD患者的首选治疗方法。一位经验丰富的移植外科医生讨论了同期胰肾移植及其未来潜在的益处。此外，临床社会工作者探讨了糖尿病患者肾衰竭、透析和移植的心理社会问题。最后，一位执业足病医生讨论了足部护理、治疗以及预防血管相关疾病这一非常重要的问题。通过这种多学科方法，可以优化糖尿病肾衰竭患者的医疗和心理社会治疗效果。
