Home About us Current issue Back issues Submission Instructions Advertise Contact Login   

Search Article 
  
Advanced search 
 
Saudi Journal of Kidney Diseases and Transplantation
Users online: 2128 Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size 
 

Table of Contents   
LETTER TO THE EDITOR  
Year : 2018  |  Volume : 29  |  Issue : 4  |  Page : 1005-1006
Diabetes mellitus and end-stage renal disease


1 Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
2 Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
3 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Click here for correspondence address and email

Date of Submission15-Nov-2017
Date of Acceptance06-Dec-2017
Date of Web Publication28-Aug-2018
 

How to cite this article:
Mousavi Movahhed SM, Beladi Mousavi SS, Akbarpour S. Diabetes mellitus and end-stage renal disease. Saudi J Kidney Dis Transpl 2018;29:1005-6

How to cite this URL:
Mousavi Movahhed SM, Beladi Mousavi SS, Akbarpour S. Diabetes mellitus and end-stage renal disease. Saudi J Kidney Dis Transpl [serial online] 2018 [cited 2019 Nov 14];29:1005-6. Available from: http://www.sjkdt.org/text.asp?2018/29/4/1005/239662
To the Editor,

With great interest, we read the recently published article by Fakhriya Alalawi et al entitled “Epidemiology of End-Stage Renal Disease in Dubai: Single-Center Data”[1] in your journal.

In this study, the author retrospectively evaluated 411 end-stage renal diseases (ESRD) patients undergoing maintenance hemodialysis (HD) in one of the biggest governmental hospitals in Dubai city from January 2012 to October 2016. Although their data represent the dialysis population in a single-center HD unit, their HD unit is the largest unit in Dubai city. HD is the most common mode of renal replacement therapy (RRT) in this city.[1]

According to the results of this study, diabetic nephropathy is the most common cause of ESRD, accounting for approximately 60% of new ESRD patients requiring renal replacement therapy in Dubai city.[1]

In Iran, few studies have been performed on the epidemiology of ESRD in recent years. Although, according to the results of these studies, different forms of glomerulonephritis were the leading causes of ESRD in the past decades, however, because of increasing prevalence of obesity, lack of awareness, and poor control of diabetes and because of more aggressive treatment of glomerulonephritis in the recent decades, type 2 diabetes mellitus is now the most common causes of ESRD requiring RRT in Iran similar to the results of Fakhriya Alalawi et al study.[2],[3],[4],[5],[6]

Unfortunately, the outcome of diabetic ESRD patients is catastrophic even in dialysis centers located in developed countries.[7],[8],[9],[10]

As an example, according to the report of the United States Renal Data System, the 5-year survival of nondiabetic ESRD patients undergoing maintenance dialysis is between 3%–50% and the 5-year survival of diabetic ESRD patients is only 25% which is significantly lower than the nondiabetic ESRD patient.[8]

The outcome of diabetic ESRD patients is also poor in Iran. As an example, in a multicenter study from Iran, we analyzed and compared 1-, 3-, 5-, 7-and 10-year survival of 1312 persons with diabetes, and nondiabetic ESRD patients referred to nine HD centers in Southwest of Iran.[10]

According to the results of our study, 1-, 3-, 5-, 7-and 10-year survival of nondiabetic ESRD patients were 82%, 50.7%, 28.6%, 13.6%, and 4.5%, respectively, which is significantly better than diabetic ESRD patients. These values (1-, 3-, 5-, 7-, and 10-year survival) among diabetic ESRD patients were 70%, 26.9%, 9%, 3.3%, and 0.6%, respectively.[10]

Poor outcome of diabetic ESRD patients compared to nondiabetic ESRD patients can be attributed to higher prevalence and the severity of comorbidity conditions including cardiovascular diseases among these patients. There are some other factors which can also contribute to the poor survival of diabetic ESRD patients including greater susceptibility to infections and foot ulcers, autonomic dysfunction and hemodynamic instability during ultrafiltration HD, vascular access problems, and a lower lifetime of fistula.[7],[10]

In conclusion, the review of Fakhriya Alalawi et al and most other studies in the world have revealed that a large number of ESRD patients have diabetic nephropathy.[2],[3],[4] Since the outcome of diabetic ESRD patients is poor, it is essential to increase the knowledge of health-care workers and people about diabetes mellitus and its complications.

It is also essential to warn people about the importance of exercise, healthy diet, and attaining a healthy lifestyle in the prevention of diabetes and diabetic nephropathy.

It is well established that early diagnosis of diabetes mellitus and screening of diabetic patients for diabetic nephropathy have an important role in the prevention and delaying the progression of diabetic patients to diabetic nephropathy.[2],[4]

Since the outcome of diabetic ESRD patients is poor, it is essential to increase the knowledge of health-care workers and people about diabetes mellitus and its complications.

It is also essential to warn people about the importance of exercise, healthy diet, and attaining a healthy lifestyle in the prevention of diabetes and diabetic nephropathy.

It is well established that early diagnosis of diabetes mellitus and screening of diabetic patients for diabetic nephropathy have an important role in the prevention and delaying the progression of diabetic patients to diabetic nephropathy.[2],[4]

It is also important to note that kidney transplantation is the preferred renal replacement therapy method for diabetic ESRD patients and it is also suggested that pre-emptive transplantation compared with transplantation after a period of dialysis has a survival advantage among CKD patients with diabetes.[4]

Conflict of interest: None declared.

 
   References Top

1.
Alalawi F, Ahmed M, AlNour H, Noralla M, Alhadari A. Epidemiology of end-stage renal disease in Dubai: Single-center data. Saudi J Kidney Dis Transpl 2017;28:1119-25.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Mousavi SS, Soleimani A, Mousavi MB. Epidemiology of end-stage renal disease in Iran: A review article. Saudi J Kidney Dis Transpl 2014;25:697-702.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Beladi Mousavi SS, Motemednia F, Beladi Mousavi M. Epidemiology of hepatitis e virus infection in patients on chronic hemodialysis. Jundishapur J Microbiol 2014;7:e6993.  Back to cited text no. 3
    
4.
Ghaderian SB, Hayati F, Shayanpour S, Beladi Mousavi SS. Diabetes and end-stage renal disease; a review article on new concepts. J Renal Inj Prev 2015;4:28-33.  Back to cited text no. 4
    
5.
Beladi Mousavi SS, Tavazoe M, Hayati F, Sametzadeh M. Arterio-venous fistula recirculation in hemodialysis: Causes and prevalences. Shiraz E Med J 2010;11:219-24.  Back to cited text no. 5
    
6.
Zeraati A, Beladi Mousavi SS, Beladi Mousavi M. A review article: Access recirculation among end stage renal disease patients undergoing maintenance hemodialysis. Nephrourol Mon 2013;5:728-32. '  Back to cited text no. 6
    
7.
Beladi Mousavi SS, Alemzadeh Ansari MJ, Cheraghian B. Outcome of patients on haemodialysis in Khuzestan, Iran. NDT Plus 2011;4:143-4.  Back to cited text no. 7
    
8.
U.S. Renal Data System. USRDS 2009 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2009.  Back to cited text no. 8
    
9.
Beladi Mousavi SS, Hayati F, Valavi E, Rekabi F, Mousavi MB. Comparison of survival in patients with end-stage renal disease receiving hemodialysis versus peritoneal dialysis. Saudi J Kidney Dis Transpl 2015;26: 392-7.  Back to cited text no. 9
    
10.
Beladi-Mousavi SS, Alemzadeh-Ansari MJ, Alemzadeh-Ansari MH, Beladi-Mousavi M. Long-term survival of patients with end-stage renal disease on maintenance hemodialysis: A multicenter study in Iran. Iran J Kidney Dis 2012;6:452-6.  Back to cited text no. 10
    

Top
Correspondence Address:
Dr. Seyed Seifollah Beladi Mousavi
Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz
Iran
Login to access the Email id


DOI: 10.4103/1319-2442.239662

PMID: 30152445

Rights and Permissions




 

Top
   
 
 
    Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  
 


 
    References
 

 Article Access Statistics
    Viewed644    
    Printed8    
    Emailed0    
    PDF Downloaded81    
    Comments [Add]    

Recommend this journal