Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Jan 1988
Renal replacement therapy in patients with diabetic nephropathy, 1980-1985. Report from the European Dialysis and Transplant Association Registry.
Diabetic nephropathy, a rarely listed cause of end-stage renal failure (ESRF) among patients starting renal replacement therapy (RRT) in the early seventies, has progressively gained in importance and become one of the major reasons for the continuous growth of the patient population on RRT in most European countries. Amongst new patients commencing RRT in 1985, the acceptance rate varied between 3 and 12 per million population for type I diabetes mellitus and between one and four per million population for type II diabetes mellitus. Nordic countries, particularly Sweden and Finland, had the highest acceptance rate of young patients with type I diabetes mellitus whose median ages were 38-42 years. ⋯ The coronary death rate was estimated to be 10 times greater in young patients with type I diabetes mellitus as compared to their non-diabetic counterparts. Other cardiovascular as well as infectious causes were recorded in a similar proportion of deaths in diabetics as in non-diabetics. Cancer deaths, however, appeared to be definitely less frequent in patients on RRT due to diabetic nephropathy.
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Nephrol. Dial. Transplant. · Jan 1988
Randomized Controlled Trial Comparative Study Clinical TrialTopical anaesthesia for fistula cannulation in haemodialysis patients.
The use of a local anaesthetic cream (EMLA; Astra) for arteriovenous fistula cannulation was compared to placebo in a double-blind randomised manner in 26 patients undergoing chronic haemodialysis who were currently using injections of lignocaine. The EMLA cream was highly effective compared to placebo (P less than 0.001) on visual analogue and verbal rating scales as well as ease of venepuncture (P less than 0.01). It also gave more pain relief and improved the ease of venepuncture compared to lignocaine injections. Patients expressed a strong preference for the EMLA cream, which has advantages that outweigh the cost and convenience factors.