The Nephrologist’s Role in the Collaborative Multi-Specialist Network Taking Care of Patients with Diabetes on Maintenance Hemodialysis: An Overview
Abstract
:1. Introduction
2. End-Stage Renal Disease (ESRD) in Patients with Diabetes: A Complex Picture
3. How to Control the Glycemic Status in Patients in Maintenance Hemodialysis?
4. Is a Tailored-Size Dialysis Technique Feasible for Patients with Diabetes?
5. Which Antidiabetic Therapy for Patients with Diabetes Undergoing Maintenance Hemodialysis Treatment?
6. What Type of Transplant for Patients with Diabetes and ESRD?
7. Conclusions
Funding
Conflicts of Interest
Abbreviations
CKD | chronic kidney disease |
ESRD | end-stage renal disease |
HbA1c | glycated hemoglobin |
GA | glycated albumin |
KDIGO | kidney disease improving global outcome |
HD | hemodialysis |
CGM | continuous glucose monitoring |
BD | bicarbonate hemodialysis |
HDF | hemodiafiltration |
BV | blood volume |
HF | hemofiltration |
AFB | acetate-free biofiltration |
IDH | intradialytic hypotension |
EDTA | European dialysis transplant association |
eGFR | estimated glomerular filtration rate |
da | daltons |
GLP-1 | glucagon-like peptide-1 |
DPP-4 | dipeptidyl peptidase 4 (DPP-4) |
SGLT2 | Sodium-glucose co-transporter 2 |
ECG | electrocardiogram |
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Advantage | Disadvantage | |
---|---|---|
HbA1c | Long-term glycemic control | Affected by reduced red blood life span and ESA |
Fructosamine | Not influenced by reduced red blood life span and ESA | Altereted by hypoalbuminemia |
Glycated albumin | Not influenced by reduced red blood life span and ESA | Altereted by hypoalbuminemia Interlaboratory variability |
Blood glucose monitor (finger prick) | Determination in blood | Time and cost consuming Not extremely accurate |
Continous Glucose Monitoring | Intensive glucose evaluation Not time consuming | Latency due to determination in interstitial fluid |
DPP-4 Inhibitors |
---|
Sitagliptin: 25 mg/daily Saxagliptin: 2.5 mg/daily Alogliptin: 6.25 mg/daily Linagliptin: No dose reduction |
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Cavallari, G.; Mancini, E. The Nephrologist’s Role in the Collaborative Multi-Specialist Network Taking Care of Patients with Diabetes on Maintenance Hemodialysis: An Overview . J. Clin. Med. 2022, 11, 1521. https://doi.org/10.3390/jcm11061521
Cavallari G, Mancini E. The Nephrologist’s Role in the Collaborative Multi-Specialist Network Taking Care of Patients with Diabetes on Maintenance Hemodialysis: An Overview . Journal of Clinical Medicine. 2022; 11(6):1521. https://doi.org/10.3390/jcm11061521
Chicago/Turabian StyleCavallari, Giuseppe, and Elena Mancini. 2022. "The Nephrologist’s Role in the Collaborative Multi-Specialist Network Taking Care of Patients with Diabetes on Maintenance Hemodialysis: An Overview " Journal of Clinical Medicine 11, no. 6: 1521. https://doi.org/10.3390/jcm11061521