RESUMO
Diabetes mellitus is one of the leading causes of end stage renal disease [ESRD] all over the world. The aim of this work was to find out the prevalence of diabetic patients among the Egyptian hemodialysis [HD] population. This work is a multicenter cross sectional study carried out in multiple HD centers all over Egypt, and involved 1000 uremic patients on regular HD. Patients were subjected to detailed history taking, full clinical examination, fundus examination. ECG, blood chemistry [including renal and liver function tests, serum calcium and phosphorous, FBS and PPBS], and complete blood picture. Patients were clinically classified into three groups. Group A included uremic patients with IDDM. Group B included uremic patients with NIDDM, and group C included uremic non diabetic patients who were taken as a patients control group. The results of this study showed that 98 patients [9.8%] out of the 1000 uremic patients studied had DM as a cause of their ESRD. Diabetic uremics were found to be more frequently hypertensive, hypercholesterolemic and suffered more from coronary heart disease than non diabetic uremics. This study also showed that the relative contribution of IDDM and NIDDM among HD patients was 38.8% and 61.2%, respectively. The, duration of NIDDM was significantly shorter indicating that the progress of renal complications in this type is much faster than in IDDM. The result of C-peptide measurement perfectly matched with the clinical criteria for classification of the type of DM. where the predictive value was 100%. Finally, this study recommends to improve the medical care given to the diabetic patients establishment of education programs for diabetics stressing upon how to avoid diabetic complications and the importance of early intervention for treatment of those complications should they occur