Dialysis in Diabetics: A Review of 44 Patients

Our experience with peritioneal dialysis and hemodialysis in diabetic patients in the Joslin Clinic for the period 1959 to 1968 shows that 44 patients received dialysis; 32 for anasarca secondary to diabetic nephropathy and congestive heart failure, 7 for an acute exacerbation of chronic renal failure, and 5 for acute renal failure. Diffuse and nodular glomerulosclerosis was found in 19 of the 26 cases with autopsies or biopsies. Best results were obtained in three patients with acute tubular necrosis following diabetic acidosis, in one patient with glutethimide intoxication, and in two patients with chronic renal disease in whom therapy was maintained with long-term hemodialysis (one of whom had successful renal transplantation). Complications of induced hyperglycemia were easily regulated by frequent injections of small amounts of regular insulin. The presence of diabetes should not contraindicate dialysis, especially in those with acute renal failure.