The diabetic on dialysis – what must the doctor pay attention to? Der Diabetiker an der Dialyse – worauf muss der Arzt achten?
Grupp C (2023)
Publication Type: Journal article
Publication year: 2023
Journal
Book Volume: 66
Pages Range: 229-237
Journal Issue: 2
Abstract
Diabetic nephropathy is currently considered the most common cause of renal failure requiring dialysis. Diabetics requiring dialysis are generally severely ill multimorbid patients with cardiovascular problems, which must also be taken into account in their care. The treatment of diabetics on dialysis is essentially based on 4 pillars: medication to control blood glucose, dietary and life-modifying measures, and the management of concomitant diseases. For drug therapy, insulin is practically the only drug available, although its demand may decrease with the progression of renal insufficiency. The HbA1c target values are higher than those for healthy kidney patients, although individual circumstances such as age and multimorbidity must be taken into account. Dietary guidelines should take care to avoid malnutrition and sarcopenia. Physical activity has a positive prognostic effect and should be encouraged. Significant is the setting of hypertension preferably involving an inhibitor of the renin-aldosterone system. In contrast, the adjustment of hypercholesterolemia by means of statins does not seem to be beneficial in this group of patients. It remains to be seen whether future studies will show the positive effects of glucagon-like peptide-1 receptor agonists and SGLT2 inhibitors on the cardiovascular prognosis of diabetics on dialysis.
Involved external institutions
Germany (DE)How to cite
APA:
Grupp, C. (2023). The diabetic on dialysis – what must the doctor pay attention to? Der Diabetiker an der Dialyse – worauf muss der Arzt achten? Internistische Praxis, 66(2), 229-237.
MLA:
Grupp, Clemens. "The diabetic on dialysis – what must the doctor pay attention to? Der Diabetiker an der Dialyse – worauf muss der Arzt achten?" Internistische Praxis 66.2 (2023): 229-237.
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