Clinical characteristic of Diabetic Nephropathy in Patients with Type 2 Diabetic Mellitus Obtaining hemodialysis: A Retrospective Analysis of 63 Cases

characteristic of Diabetic Nephropathy in Patients with Type 2 Diabetic Mellitus Obtaining hemodialysis: A Retrospective Analysis


Introduction
Diabetes prevalence is increasing worldwide, with the highest increases in low-and middle-income countries. In most developed countries, type 2 diabetes is currently the main cause of end-stage renal failure and also contributes significantly to cardiovascular disease. In countries with weaker economies, type 2 diabetes is rapidly replacing infectious diseases as a leading cause of kidney disease and is increasingly competing for scarce health resources.
The frequency of chronic renal failure varies in different countries in the range of 100-600 per 1 million adults. Moreover, 50-100 new cases of uremia are registered annually. There is a different frequency of chronic renal failure in different age groups: from 4-10 cases per 1 million in children to 1-3 cases per 10,000 in adults, especially in people over 70 years of age. This is due to the fact that with age, the structure of the causes of chronic renal failure significantly changes, new etiological factors appear. While in children mainly chronic hereditary and congenital nephropathies lead to chronic renal failure: Alport syndrome, cystinosis, reflux nephropathy, in adults -acquired primary and secondary nephropathies.
In older people, the cause of chronic renal failure can be metabolic and vascular diseases (diabetes mellitus, gout, hypertension, atherosclerosis), urological and oncological diseases, the use of drugs, especially polypharmacy, etc. [1]. In order to unify approaches to the diagnosis, treatment and prevention of renal pathology in 2002, associations of nephrologists and hemodialysis doctors from Europe and the USA -NKF / KDOQI (National Kidney Foundation / Kidney Disease Outcomes Quality Initiative) proposed a new term: Chronic kidney disease chronic kidney disease). CKD is defined as damage to the kidneys or a decrease in their function within three months or more, regardless of diagnosis [2]. Changes in the nervous system in patients with CKD stage V largely determine their fate, being the cause of persistent disability and death [3]. Until now, the unsolved problem is the search for adequate treatment for patients with end-stage chronic renal failure, with various neurological complications, developing with the use of hemodialysis [4,5]. According to various authors, the frequency of neurological manifestations in patients receiving hemodialysis is from 40 to 90% [6,7], Mortality from neurological complications is 7-25%, and among patients with advanced cerebrovascular accident: 80-90% [8]. to various authors, occurs in 80-100% of patients [11] and is a risk factor for morbidity and mortality from cardiovascular and cerebrovascular diseases [12,13]. The higher the systolic blood pressure and the longer arterial hypertension exists, the greater the degree of atrophy of the brain. G.M. Savazzi studied the degree of brain atrophy in patients with verified arterial hypertension who received treatment with programmed hemodialysis using computed tomography. Patients under the age of 55 were included in the study group to exclude the effect of age-related changes [14][15][16][17][18]. When conducting computed tomography in all patients, cerebral atrophy of varying severity was revealed. All of the above was the reason for the present study.

Aim of the Study
To study the clinical characteristic of the patients with type 2 diabetes mellitus.

Material and Methods
We examined and examined in total for the period from The significance of differences in the level between the groups was estimated by the value of the confidence interval and Student's criterion (p). Differences were considered statistically significant at p <0.05 [19,20]. Table 1 shows the distribution of the examined patients by gender and age. As can be seen from Table 1, patients in the age category from 60 to 74 years prevailed among both men and women -18/20 cases, respectively. As can be seen from Table 2 Table 3 shows the frequency of concomitant diseases identified in patients in groups. As follows from Table 3       Note: SAP -systolic arterial pressure, * -significance of differences with control, where * -p <0.05, ** -p <0.01.

Results and Discussion
As can be seen from Table 4, we found a reliable association between the risk of heart failure and age, the duration of diabetes for more than 15 years, the presence of retinopathy, 24-hour b) The prevalence of DN is high in patients with DM 2 type manifesting heavy proteinuria.