Stage 5: ESRD

出自KMU Wiki

• 15-30th year
• Brittle diabetes
  • Large swings in plasma glucose level
  • More often low plasma glucose level or hypoglycemia due to
    • Insulin degradation ↓
    • Renal gluconeogenesis ↓
  • Thus, diabetic patients with decreasing plasma glucose levels may sometimes suggest declining renal function
  • Less often high due to insulin resistance ↑
• Both DM and end-stage renal disease are systemic dis.
  • Microangiopathy, retinopathy, neuropathy, macroangiopathy (cardiovascular disease, atherosclerosis, coronary heart disease), hyperlipidemia, foot ulcer
  • Dialysis is indicated at an earlier stage (serum creatinine ≥ 5~6 mg/dl) than the other uremic p'ts
  • Morbidity and mortality are higher than other ESRD p’ts
  • Renal transplantation