Dissertation > Excellent graduate degree dissertation topics show

Retrospective Analysis the Risk Factors of Hemodialysis for Diabetic Nephropathic Patients

Author: JiShunXian
Tutor: HeQiang
School: Zhejiang University
Course: Nephrology
Keywords: Diabetic Nephropathy End Stage Renal Disease Hemodialvsis
CLC: R587.2
Type: Master's thesis
Year: 2011
Downloads: 50
Quote: 0
Read: Download Dissertation

Abstract


Purpose:The object of this study was to compare the effectivity and safety of hemodialysis for both diabetic and nondiabetic end-stage renal disease patients, to observe whether there are risk factors for diabetic individuals, and give a suggestion of how to administrate diabetic patients during hemodialysis for clinicians.Method:A Retrospective study was carried out with 34 diabetic and 43 nondiabetic patients, all of them started and continued hemodialysis in our center from December 1st,2007 to October 1st,2010 were included. Collect information of patients’ characteristics, assessments before the first dialysis, records of pre- and post-dialysis each time, complications during the follow-up period, and so on. All of the data was collected from the electronic system in our center. Chi-test was made to analyses difference between diabetic and nondiabetic patients for disaggregated data, while T-test for continuous data.Result:There are no differences of age, gender, and dialysis age between the two group. The diabetic nephropathic patients (DNs) significantly higher and heavier than the nondiabetic patients (nDNs), and the body mass index (BMI) had a higher trend as well(22.50±3.37kg/cm2 vs 21.37±2.94 kg/cm2). Before the first dialysis, there was a higher systolic blood pressure (SBP) in DNs (163.6±16.6mmHg vs 155.7±23.3mmHg, P=0.09), and SBP pre- and post-dialysis for each time were also higher,161±17mmHg vs 148±14mmHg and 155±16mmHg vs 144±14mmHg,respectively. DNs started dialysis in lower serum creatinine, blood urea nitrogen, parathyroid hormone, and albumin, P value of the differences are all less than 0.05. However, the cardiac function assessment had no difference between these two group, neither the left ventricle ejection fraction(LVEF), nor the left ventricle mass index(LVMI). There were 85.3% DNs and 72.1%nDNs had a disciplinary hemodialysis (>=3 time per week). Both the average dialysis duration were more than 3 hours, and the Kt/V were more than 1.4. Increasing body weight during dialysis interval was more for DNs (3.62%±0.88% vs 2.25%±1.22%, P<0.000001). During our limited observation (612±297d vs 565±272d), the over-survival was similar for the two groups. However, the complication risks were higher in individuals with diabetes, especially cardiovascular and cerebrovascular events, as well as infections.Conclusion:Hemodialysis is a feasible renal replacement therapy for end-stage diabetic nephropathy patients, and these patients usually have a lot of co-morbidities and complications, and need to dialysis in earlier stage. These patients have a higher risk than nondiabetic individuals, due to the poor health basis and the extensive vascular lesions of the whole body. The clinicians should pay more attention on the blood pressure, body weight control and administrate complications as early as possible.

Related Dissertations

  1. Analysis of the Relationship between the Expression of SARA and the Pathological Types and Clinical Phenotypes of Diabetic Nephropathy,R587.2
  2. The Curative Effect Comparison between Hemodialysis and Continuous Ambulatory Peritoneal Dialysis on End Stage Diabetic Nephropathy,R587.2
  3. Effects of Cordyceps Sinensis and Tripterygium Wilfordii Polyglycosidium on the Podocytes in Rats with Diabetic Nephropathy,R285.5
  4. Effect of Metformin and Repaglinide on the Expression of TGF-β1 mRNA in Diabetic Mouse Kidney,R587.1
  5. The Relationship Analysis Between Activated Protein C (APC) and Urinary Microalbumin and Lower Extremity Vascular Disease in Patients with Type 2 Diabetes Mellitus,R587.2
  6. The Experimental Study of Histopathology and Integrated Backscatter in Diabetic Nephropath Rats,R692.9;R445.1
  7. Effects of AngⅡ, ET-1 and HIF-1α on Renal Interstitial Fibrosis in Diabetic Nephropathy and Study on the Intervention,R692.9
  8. Protection of Myeophenolate Mofetil in Kidney of Diabetes Rat,R965
  9. The Role of Myo-inositol Oxygenase in the Pathogenesis of Diabetic Nephropathy,R587.2
  10. Granules Compound Gushen senile diabetic nephropathy Kidney Blood type proteinuria clinical observation,R277.5
  11. The Effect of Shenxiao Prescription on Protein Kinase C of Diabetic Nephropathy Rats,R285.5
  12. Diabetic rat kidney tissue changes in the level of hydrogen sulfide synthase and hydrogen sulfide on mesangial cell proliferation studies,R587.2
  13. Serum fractalkine factor and type 2 diabetic nephropathy study,R587.2
  14. Diagnostic Signifcance of Assay of Serum Retinal-Binding Protein in Early Diabetic Nephropathy,R587.2
  15. Fluvastatin Decreases the Expression of Fibronectin by Inhibiting the Signal Passageway of Rho-kinase in HK-2 Cells,R587.2
  16. The Clinical Observation of Fuzhenghuayu Soup Treating Diabetic Nephropathy (Syndrome of Stasis Due to Deficiency of Both Qi and Yin),R259
  17. TCM retention enema treatment of diabetic nephropathy,R259
  18. Clinical Observation of Early Stage Diabetic Nephropathy in Treatment with Tonifying Kidney-Thirst Mixture,R259
  19. Correlation between Serum TNF-a, IL-18, ADPN and Type 2 Diabetic Nephropathy,R692.9
  20. The Clinical Significance of Measuring Serum Levels of Soluble Cell Adhesion Molecule in Diabetes Nephrosis,R692.9

CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Islet disease > Diabetic coma and other complications
© 2012 www.DissertationTopic.Net  Mobile