While survival on dialysis continues to improve, diabetic patients still do less well than non-diabetic patients (6). Results from the Italian Cooperative Peritoneal Study Group Registry show the 10-year patient survival for the 301 diabetic patients to be less than half that of the 1689 non-diabetic subjects (20.6% vs 55.6%) (7). Higher mortality rates among diabetic patients receiving HD also occur (8), but with good glycaemic control these rates can be improved (9).
Peritoneal dialysis is the preferred mode of treatment for diabetic patients with microvascular and macrovascular co-morbidities. Continuous ambulatory peritoneal dialysis allows for a slow ultrafiltration process that provides greater cardiovascular stability than HD. Blood pressure control is easier and residual renal function is preserved for longer. It also provides incidentally for an alternative route of insulin administration. Initial concerns that diabetic CAPD patients may have higher dialysis-associated infection rates have not been confirmed (10,11).
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