Abstract
The aim of the study was to determine the outcome in 181 diabetic patients with advanced, previously untreated renal impairment who had been identified in a survey conducted in six health regions in the United Kingdom in 1985. Late in 1987 questionnaires were sent to the consultant physicians, geriatricians, and nephrologists who had reported on the 181 patients, asking whether the patient had started receiving dialysis, had received a transplant, or had died. In all, 176 of the patients were traced, 164 having either died or received renal support treatment by the end of 1986. Nearly two thirds (107) of the patients received renal support treatment, which was renal transplantation in five and dialysis in 102. This is an increase on previous years. A third of the patients (57) died without having received renal support treatment. In 15 patients death was unavoidable and mainly from acute myocardial infarction (10 patients), but 28 patients (half of those who died untreated) died from renal failure, sometimes with fluid retention that was ascribed to heart failure (18 patients). Most of the patients would have benefited from renal support treatment. This neglect should no longer occur.