RT Journal
A1 Rosansky SJ
T1 THe sad truth about early initiation of dialysis in elderly patients
JF JAMA
JO JAMA
YR 2012
FD May 9
VO 307
IS 18
SP 1919
OP 1920
DO 10.1001/jama.2012.3522
UL http://dx.doi.org/10.1001/jama.2012.3522
AB 
Forty years ago, an article in JAMA entitled “The Sad Truth About Hemodialysis in Diabetic Nephropathy” highlighted the poor outcomes for patients with diabetes who were treated with dialysis.1 In the early 1970s some patients with diabetes were not offered dialysis because of expected poor outcomes. The problems of visual deterioration and chronic fluid overload have been largely resolved with laser therapy for diabetic retinopathy and vastly improved dialysis techniques. In a report published in 1972, among 9 patients with renal failure resulting from diabetic nephropathy who were treated by hemodialysis, survival was 22% (2 patients) at the end of 1 year,1 whereas in 2008, data from the US Renal Data System indicate that for patients with diabetes who initiated dialysis, survival was 81% at the end of 1 year.2