Evaluation of overhydration in diabetic patients at the beginning of regular dialysis treatment

Sixty-nine diabetic patients with end-stage renal failure (40 men and 29 women; mean age 59 years old) were studied for the effects of overhydration on their clinical picture, dialysis methods and mortality. The presence of pulmonary edema, enlarged cardiothoracic ratio, pleural effusion, ascites or pericardial effusion were defined as overhydration. There were no differences in the sex, age, duration of diabetes and insulin usage between the patients with or without overhydration. The initial levels of serum creatinine, total serum protein and partial pressure of blood oxygen were slightly lower, and proteinuria was higher in the patients with overhydration. The mortality during the 3 months of chronic dialysis was higher in the patients with overhydration. The frequency of emergency dialysis, dialysis time and the volume of ultrafiltration within the 10 days were higher in the patients with overhydration. After 1984, we started the dialysis treatment earlier in patients with overhydration. As a result, their mortality was slightly improved. In conclusion, early dialysis treatment is recommended for over hydrated diabetic patients.