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oai:docta.ucm.es:20.500.14352/45522024-10-09T12:42:32Zcom_20.500.14352_14col_20.500.14352_15
Docta Complutense author Buades, Juan M. author Craver, Lourdes author Del Pino, Maria Dolores author Prieto Velasco, Mario author Ruiz, Juan C. author Salgueira, Mercedes author De Sequera Ortiz, Patricia author Vega, Nicanor 2023-06-16T14:17:36Z 2023-06-16T14:17:36Z 2021-06-30 2077-0383 10.3390/jcm10132943 https://hdl.handle.net/20.500.14352/4552 https://doi.org/10.3390/jcm10132943 https://www.mdpi.com/2077-0383/10/13/2943 Diabetic kidney disease (DKD) is the most frequent cause of kidney failure (KF). There are large variations in the incidence rates of kidney replacement therapy (KRT). Late referral to nephrology services has been associated with an increased risk of adverse outcomes. In many countries, when patients reach severely reduced glomerular filtration rate (GFR), they are managed by multidisciplinary teams led by nephrologists. In these clinics, efforts will continue to halt chronic kidney disease (CKD) progression and to prevent cardiovascular mortality and morbidity. In patients with diabetes and severely reduced GFR and KF, treating hyperglycemia is a challenge, since some drugs are contraindicated and most of them require dose adjustments. Even more, a decision-making process will help in deciding whether the patient would prefer comprehensive conservative care or KRT. On many occasions, this decision will be conditioned by diabetes mellitus itself. Effective education should cover the necessary information for the patient and family to answer these questions: 1. Should I go for KRT or not? 2. If the answer is KRT, dialysis and/or transplantation? 3. Dialysis at home or in center? 4. If dialysis at home, peritoneal dialysis or home hemodialysis? 5. If transplantation is desired, discuss the options of whether the donation would be from a living or deceased donor. This review addresses the determinant factors with an impact on DKD, aiming to shed light on the specific needs that arise in the management and recommendations on how to achieve a comprehensive approach to the diabetic patient with chronic kidney disease eng Atribución 3.0 España Management of Kidney Failure in Patients with Diabetes Mellitus: What Are the Best Options? journal article URL https://docta.ucm.es/bitstreams/9f0ecfff-3ae1-4a40-879a-d057553824fe/download File MD5 0a97159df946ef8f7a60135f0ec76d37 841791 application/pdf jcm-10-02943-v2.pdf