2015年11月23日星期一

Hemodialysis or Peritoneal Dialysis: Which Is Better for Patients with Diabetes

With the changing of life styles, more and more people are diagnosed with Diabetes. As a result, the dialysis rate in the patients with Diabetes also increases. Hemodialysis and peritoneal dialysis are two dialysis methods for the patients. Then which one is better for the patients with Diabetes?

Both of hemodialysis and peritoneal dialysis have its advantage and disadvantages.

It is very difficult for the patients with Diabetes to maintain long-term peritoneal dialysis. As peritoneal dialysis is very likely to induce infection, especially peritonitis, it can decline the therapeutic effect to the patients. Moreover, there is a large amount of glucose in the peritoneal fluid. It can disorder the blood glucose balance thus make it difficult control blood glucose. As a result, the incidence of obesity and high fat will increase. Peritoneal dialysis usually operated by the patients themselves. However, many patients with Diabetes have visual disturbance, which can influence the operation of peritoneal dialysis.

Hemodialysis also can bring many troubles for the patients with Diabetes. As the patients with Diabetes often are complicated with vascular diseases, it can often block vascular access and shorten the usage age of internal fistula. Moreover, in hemodialysis, the patients need to use heparin to prevent blood coagulation. As a result, the patients with Diabetes on hemodialyis are very likely to have severe cerebral hemorrhage and fundus hemorrhage. As the patients with Diabetes often have neurological abnormalities, the incidence of hypotension among the dialysis patients is very high. Hemodialysis also can lead to hemodynamic abnormalities. If the patients with Diabetes are complicated with server cardiovascular diseases, hemodialysis will aggravate the primary diseases.

In a conclusion, peritoneal dialysis just has a mild influence on haemodynamics and also can clear the moderate molecular toxic substance in the blood. Moreover, in peritoneal dialysis, the patients can get insulin from dialysis fluid directly and do not need subcutaneous injection of insulin, which is more convenient and can decline their sufferings greatly. Moreover, peritoneal dialysis does not need heparin so it can decline the incidence of fundus hemorrhage and cerebral hemorrhage. Therefore, if the patients with Diabetes complicated with severe cerebrovascular diseases, peritoneal dialysis is their better choice. However, if they keep physique very well and have good blood vessels, they also can consider using hemodialysis.


Therefore, the patients with Uremia caused by Diabetes should consider their disease condition comprehensively and then decide which type of dialysis method is better for them.

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