CURRENT STATUS OF ELDERLY DIABETIC PATIENTS ON MAINTENANCE HEMODIALYSIS IN NARA PREFECTURE

Abstract

The clinical characteristics of elderly hemodialysis patients with diabetes mellitus (DM) were compared with those with non-diabetic renal diseases (NDM). The subjects were 432 patients over 65 years of age undergoing maintenance hemodialysis at 28 dialysis centers in Nara Prefecture. The presence or absence of 8 different co-morbid illnesses was ascertained for each study patient. These conditions included congestive heart failure (CHF), ischemic heart disease (IHD), cerebrovascular disease (CVD), peripheral vascular disease (PVD), serious infections, severe visual disturbance, malnutrition and dementia. The prevalence of complications related to CHF, IHD, CVD, PVD, and severe visual disturbance was significantly higher in DM than in NDM. Activities of daily living (ADL) status was also evaluated. Degree of conditions of ADL was divided into four classes : no disability, needs assistance, wheelchair use, and bedridden. Disability of ADL was observed in 34.9% of DM patients and 22.3% of NDM patients (p<0.01). The mean numbers of co-morbid illnesses in the no disability and bedridden classes were significantly higher in DM than in NDM. We conclude that cardiovascular complications and visual disturbance are the main causes of disability in elderly diabetic patients undergoing hemodialysis.