02/11/2002
By David Loshak
The rate of decline in renal function in patients starting dialysis can be almost halved in clinical practice. This is comparable to the major reductions achieved by interventions, especially blood pressure control, used in clinical trials.
Noting that diabetic nephropathy is the most common cause of end-stage renal failure in patients beginning dialysis, specialists at Glasgow Royal Infirmary, Glasgow, Scotland, studied demographic and laboratory data on 170 consecutive patients referred to a combined diabetic-renal clinic over the course of 10 years.
Median serum creatinine at referral was 170 µmol/l and exceeded 350 µmol/l in 26 percent of patients. Mean blood pressure was 159/85 mmHg. Guidelines by the Scottish Intercollegiate Guidelines Network recommending more active intervention and earlier referral had no impact on referral blood pressure and creatinine.
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