Epidemiologic analysis of diabetic patients on chronic dialysis.
Epidemiologic analysis of diabetic patients on chronic dialysis.
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慢性透析糖尿病患者流行病学分析
作者：
H. Sunagawa;K. Iseki;K. Nishime;H. Uehara;S. Toma;K. Kinjo;K. Fukiyama
我们回顾性调查了 404 名（191 名女性和 213 名男性）慢性透析患者的所有可用医疗记录，其中 16 名（4%）患有胰岛素依赖型糖尿病（IDDM）和 388 名（96%）非胰岛素依赖型糖尿病（NIDDM）。这些患者属于日本冲绳 2,214 名透析患者，其中 443 名患有糖尿病。患者进入了一个大型的基于人群的透析登记处。 IDDM 患者从诊断糖尿病 (DM) 到透析的平均时间为 181.6 个月，NIDDM 患者为 150.4 个月。根据首次怀疑 DM 时的状态，NIDDM 患者被分为四个亚组。从诊断 DM 到开始透析治疗的持续时间明显短于任何其他亚组或患有主要血管疾病的 IDDM 亚组（131.9 个月）。除此之外，NIDDM 患者的肾脏疾病病程与 IDDM 个体相似。我们大多数患有 DM 的透析患者患有 NIDDM。大多数 NIDDM 患者的诊断因不明原因被推迟了数年。然而，如果早期诊断，NIDDM 表现出与 IDDM 相似的直至透析的临床时间过程。 NIDDM 患者患慢性肾病的发病率是否与 IDDM 患者相同，以及接受慢性透析的所有糖尿病患者的比例仍有待确定。
We retrospectively surveyed all of the available medical records of 404 (191 females and 213 males) chronic dialysis patients, of whom 16 (4%) had insulin-dependent diabetes mellitus (IDDM) and 388 (96%) non-insulin-dependent diabetes mellitus (NIDDM). The patients were among 2,214 dialysis patients in Okinawa, Japan, of whom 443 were diabetic. The patients entered a large population-based dialysis registry. The mean duration from the diagnosis of diabetes mellitus (DM) to dialysis was 181.6 months in the IDDM patients and 150.4 months in the NIDDM patients. The NIDDM patients were classified into four subgroups according to their status when DM was first suspected. The duration from the diagnosis of DM until the onset of dialysis treatment was significantly shorter than in any other subgroup or in the IDDM subgroup with major vascular disease (131.9 months). Otherwise, the course of renal disease in NIDDM patients was similar to that in IDDM individuals. Most of our dialysis patients with DM had NIDDM. In most of the NIDDM patients, the diagnosis had been delayed for several years for unknown reason. However, if diagnosed early, NIDDM shows a clinical time course until dialysis similar to that of IDDM. Whether NIDDM patients contract chronic renal disease at an equal incidence to that of IDDM patients and the fraction of all diabetic patients accepted for chronic dialysis remain to be determined.