Cristiana David

Preoperative status of diabetic and non-diabetic chronic dialyzed patients – therapy implications

Abstract Background and Aims: The evaluation of preoperative status of diabetic chronic dialyzed patients consists in determining the preoperative risk factors and choosing the optimal surgery time to reduce further complications. Material and method: we conducted a retrospective study that included 156 chronic dialyzed subjects (diabetic and non-diabetic patients) undergoing surgical interventions, between 2010 and 2013. The incidence of preoperative parameters considered as risk factors (e.g.: cardiovascular, cerebrovascular or pulmonary diseases, anemia, nutritional and inflammatory status) was compared between the 2 groups of patients. Results: the diabetic group compared to the non-diabetic one presented a statistically significant higher value of the following variables: obesity (29.8% vs. 8%, p<0.05), ischemic cardiovascular disease (100% vs. 85.8%, p<0.05), congestive heart failure (100% vs. 79.7%, p<0.05), peripheral vascular disease (42.1% vs. 7%, p<0.05), stroke sequelae (12.28% vs. 3.03%) and elevated Creactive protein levels (4.01±5.4 vs. 6.34±10.28, p<0.05). There were no statistically significant differences between the 2 groups regarding: age, smoking status, hypertension, mean hemoglobin, serum albumin, and chronic lung diseases prevalence (p>0.05). Conclusions: considering the high prevalence of cardiovascular diseases in diabetic patients, the preoperative evaluation of dialyzed diabetic individuals should be performed thoroughly, emphasizing the diagnosis and staging of cardiovascular diseases, chronic lung diseases and nutritional status.