Peculiarities of diabetic nephropathy: A case report

This is a case of a 55 -year old man with type 2 diabetes mellitus with hypertension who defaulted clinical visits and was subsequently brought to the accident and emergency department with acute deterioration of kidney function. He had five sessions of haemodialysis with some episodes of intradialysis hypotension in the first three sessions. This case was selected for reporting in order to highlight four pertinent issues in the management of the diabetic patient with nephropathy which this patient manifested. These include onset of severe anaemia at relatively earlier stage of chronic kidney disease (CKD) compared to non-diabetic renal diseases and development of clinical features of uraemia at a lower level of serum creatinine compared to patients with non-diabetic renal disease. Other non-specific characteristics include high risk of intra-dialytic hypotension and high risk of failure of arterio-venous fistula maturation.