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• W1606388051 abstract "Diabetic nephropathy is the most common cause for end-stage renal disease (ESRD). Chronic renal failure is associated with miscellahous alterations in carbohydrate and insulin metabolism.. Moreover, several specific therapies employed in renal insufficiency also influence pharmacological therapy of diabetes in uraemic patients.. In patients with altered renal function, therapeutic possibilities are limited due to the accumulatin of some oral agents and/or their metabolites at the reduced glomerular filtration rate (GFR). The connection between kidney and insulin metabolism is well known for many years (Horton et al, 1968). For insulin metabolism the kidneys are one of its target organs. Chronic renal failure is associated to multiple alterations in the carbohydrate and insulin metabolism that should be taken into account when treating diabetic patients with altered renal function (DeFronzo et al, 1973). Specific therapeutic needs (oral agents or insulin) will be determined based on the degree of insulin resistance or insulin deficiency of patients with renal insufficiency (Rabkin e al,1984). A good metabolic control is not only important in the early phase of diabetic nephropathy but also in diabetic patients with ESRD. It was shown in several studies, that metabolic control under antidiabetic therapy is a predictor for prognosis of patents with renal replacement therapy (Morokia et al, 2001). A good glycemic control can reduce the progression of atherosclerosis (Oomichi et al, 2006) and improve the survival in patients treated with hemodialysis (Kovesdy et al, 2008). Though, in a recent study it was suggested that aggressive glycemic control cannot be routinely recommended for all diabetic hemodialysis patients on the basis of reducing mortality risk (Williams et al, 2010). The majority of uremic type 2-diabetic patients need insulin, however, a smaller part of these diabetic patients can also be treated with oral antidiabetic agents. The problem of the topic of this study is the fact, that there are only few data in the literature concerning antidiabetic therapy in type 2 diabetic patients with ESRD (Biesenbach et al, 2010). This paper offers a review of the relevant findings related to insulin therapy in diabetic patients with ESRD. Additionally, we review the relevant aspects related to oral antidiabetic therapy in diabetic patients with impaired renal function." @default.
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• W1606388051 date "2011-11-14" @default.
• W1606388051 modified "2023-09-25" @default.
• W1606388051 title "Antidiabetic Therapy in Type 2 Diabetic Patients on Hemodialysis" @default.
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• W1606388051 doi "https://doi.org/10.5772/24416" @default.
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