Long-term follow-up of 369 diabetic patients undergoing dialysis.

We studied the long-term outcome (after four years) in 233 patients with type I and 136 with type II diabetes mellitus treated with long-term dialysis between 1966 and 1982. The seven-year cumulative survival improved from 12% before 1976 to 20% after 1976. Sixty-eight of the patients survived for more than four years, and 25 are still alive. Of deaths, 51% were due to cardiovascular disease, 24% to the discontinuation of dialysis, 14% to infections, and 11% to other causes. Over the course of the study, older and sicker patients were increasingly accepted for dialysis, and younger and healthier patients were increasingly accepted for transplantation. The 25 patients who are still alive and undergoing dialysis were hospitalized 1.4 times per patient year for 19 hospital days per patient year the first year and for eight days per patient year after that. Two became blind, three had amputations, seven worked full-time. The results of long-term dialysis in patients with diabetes have improved greatly over the last two decades.