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FEATURES OF MAINTAINING RENAL FAILURE IN PATIENTS WITH DIABETES
MELLITUS ON GEODIALYSIS
Turdiyev Qilichbek Toshqobilovich
Samarkand regional Multidisciplinary Medical
Center-Head of the Department of hemodialysis.
Maxmonov Lutfullo Saydullayevich
Head of Department of Hematology of SamMU PHD.
Xaqberdiyev Zubaydullo Saydullayevich
Samarkand regional Multidisciplinary Medical Center-ordinator of the
Department of hemodialysis.
Madasheva Anajan Gazxanovna
SamMU Department of Hematology PHD
Annotatsiya:
qandli diabet bilan og'rigan bemorlarda buyrak etishmovchiligini boshqarish
Melitus Mellitus, keng qamrovli yondashuvni talab qiladigan murakkab qiyinchiliklarni keltirib
chiqaradi. Diabetik nefritatiya surunkali buyrak kasalligining etakchi sabablaridan biri bo'lib,
ko'pincha buyrakni almashtirish terapiyasiga ehtiyoj paydo bo'ladi. Ushbu hujjatda ushbu
bemorlarga, shu jumladan glikemik nazorat, qon bosimini boshqarish, elektrolitlarni boshqarish,
elektrolitlarni boshqarish, parhez optimallashtirishning asosiy jihatlarini o'rganadi.
Kalit so’zlar:
Diabet Melitus, buyrak etishmovchiligi, glycemiya nazorati, gemodializ,
elektrolitlar nomutanosibligi, dietani boshqarish, insulin terapiyasi, bemor ta'lim.
Аннотация
:У пациентов с диабетом почечная недостаточность приводит к сложным
трудностям, которые требуют комплексного подхода, который требует комплексного
подхода. Диабетический нефритический является одной из ведущих причин хронического
заболевания почек, и часто необходимость замены заместительной почечной терапии. В
документе объясняются основные аспекты этих пациентов, включая гликемический
контроль, управление артериальным давлением, лечение электролитов, оптимизация
питания.
INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
American Academic publishers, volume 05, issue 02,2025
Journal:
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page 1482
Ключевые слова:
диабет мелит, почечная недостаточность, контроль скольжения,
гемодиализ, дисбаланс электролитов, лечение диеты, инсулиновая терапия, обучение
пациентов.
Annotation
:In patients with diabetes, the kidney failure leads to complex difficulties that require
a comprehensive approach, which require a comprehensive approach. Diabetic Nephrithic is one
of the leading reasons for chronic kidney disease, and often the need to replace renal replacement
therapy. The document explains the main aspects of these patients, including glycemic control,
blood pressure management, electrolytes management, dietary optimization.
Key words
:diabet melitus, renal failure, glides control, hemodialysis, electrolytes imbalance,
diet management, insulin therapy, patient teaching.
Introduction.Currently, more than half a billion people in the world are suffering from
diabetes. According to forecasts, by 2030, the number of patients with this disease can reach up
to 1.3 billion. This is due to the increase in circumstances of disability.According to scientists,
the excessive weight gain of diabetes caused by malnutrition is the main factor that occurs. In
this fragrance, renal cells are damaged and their ability to filter decreases.This will eventually
lead to chronic renal failure development. At the same time, the function of the kidneys requires
a strict and continuous diet and long-term medications .Diabetes, sugar disease is a disease
caused by the organism caused by insulin shortage and metabolic interpretation of
substances. KANED DIFICIENY is already known in the history of oriental folic medicine. Abu
Ali ibn Sina paid special attention to this disease. "It turns out how long water is drank," he
writes. The patient's drinking of the patient also causes other diseases, and the patient is very low.
Stoping the treatments: "The patient said to drink cold-free liquids, slippers, drink fruits, and
drink the patient, that is, wetting the patient." This means that the disease emerges due to an
increase in heat in the human div. According to sugar disease, according to historical medical
sources, can be a given her. In diabetes, in diabetes, blood substance increases sharply and is
followed by the urine symptoms, symptoms, dashes, loss, infirmity, divching, etc..The disease
is divided in hereditary or life, as well as insulin (1th centuries of diabetes) and not related to
insulin (2tes).The 1 type of diabetes is often found in adolescence. In this case, the pancreatic
cells cannot produce insulin and insulin drugs are used to reduce the amount of sugar in their
treatment.In 2 rounds of diabetes, insuline production is maintained from pancreas, the amount
of insulin in blood is normal or higher. Diabetes mellitus is a growing epidemic and is the most
common cause of chronic kidney disease (CKD) and kidney failure. Diabetic nephropathy
affects approximately 20–40 % of individuals who have diabetes,making it one of the most
common complications related to diabetes. Screening for diabetic nephropathy along with early
intervention is fundamental to delaying its progression in conjunction with providing proper
glycemic control. Given the growing population that is now affected by diabetes and thus,
nephropathy, knowledge regarding the safe use of various anti-hyperglycemic agents in those
with nephropathy is of importance. In addition, attention to modification of cardiovascular
disease (CVD) risk factors is essential. Altogether, knowledge regarding the prevention and
management of diabetic nephropathy, along with other aspects of diabetes care, is part of the
comprehensive care of any patient with diabetes. In type 1 diabetes, a number of studies show
the development of microalbuminuria is associated with poorer glycemic control. In the DCCT,
intensive therapy in patients with type 1 diabetes (mean A1c 9.1 % vs. 7.2 %) reduced the
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occurrence of microalbuminuria by 34 % in the primary prevention group and 43 % in the
secondary intervention group (who had known early complications at baseline); risk reduction in
progression to clinical albuminuria was also seen.To assess whether risk reduction of diabetic
nephropathy persists long-term, the EDIC Study demonstrated there were fewer cases of new
microalbuminuria and progression to albuminuria in the original intensive group. In this long-
term follow-up study of the original DCCT treatment groups, it was shown that intensive
treatment did result in a significant decrease in the development of estimated GFR levels of
<60 ml/min/1.73 m2. In patients with type 2 diabetes, the Kumamoto study, UKPDS and
Veterans Affairs Cooperative studies showed reduction of new onset nephropathy and
progression of nephropathy with intensive glycemic control. A systematic review and meta-
analysis of 7 trials evaluating intensive glucose control on kidney-related end points in patients
with type 2 diabetes showed lower risk of developing microalbuminuria and macroalbuminuria.
The intensive control groups had a median A1c ranging from 6.4–7.4 %. The A1c difference in
the intensive groups compared to the control groups ranged from 0.6–2.3 %, with 4 of the studies
demonstrating an A1c difference of more than 1 %. The analysis also found there was no benefit
in regards to doubling of serum creatinine, development of ESRD or death related to kidney
disease.The ACCORD study showed higher risk of hypoglycemia and mortality in patients with
type 2 diabetes treated with intensive glucose control (mean A1c 6.4 % vs. 7.5 %), without any
risk reduction on CVD. The increased mortality could not be attributed to hypoglycemia.In the
ADVANCE trial, more intensive glycemic control (A1c 6.5 % vs. 7.3 %) showed no reduction in
CVD. However, the intensive group had a 21 % reduction in nephropathy .The VADT study
(intensive group with A1c 6.9 % vs. 8.4 %) also showed no benefit on CVD risk with stricter
glucose control .The data clearly show that lowering A1c leads to benefit in regards to
nephropathy. Benefits in A1c reduction are also seen on rates of retinopathy and neuropathy.
However, the effect of lowering A1c is much less in regards to macrovascular disease. Thus, it is
reasonable that a target A1c ~7.0 % offers an optimal risk to benefit ratio rather than a target that
is considerably lower.Diabetes - a lifelong disease, it is necessary to treat it throughout life. In
the high-tempered patients that are not treated and blood long, the vascular complications of
diabetes - diabetes specific (macro and micropathies) are represented in high-term patients.It
damages the capillaries of all members (skin, muscles, nerve, etc.). Diabetic microphosiles are
observed in members more and more early in the kidneys, eye, foot and others.The development
of diabetics Atheroslerosis, in turn, leads to the heartbeat disease (stanocardium, myocardium
infarction), brain infringement (dizziness, brain spaces) and so on. DM is a metabolic disease
that causes renal failure, and renal failure increases the need for insulin in diabetic. The
accumulation of uremic toxins and increased parathyroid hormone levels in patients with chronic
renal failure (CRF) cause insulin resistance in tissues, particularly skeletal muscle tissues. This
has been attributed to damage in the process after insulin binding to its receptors, which disturbs
glucose metabolism and glycogen production.It also seems that anemia caused by CRF has an
impact on insulin resistance, and the correction of anemia by erythropoietin has been shown to
increase insulin sensitivity in the div.Insulin secretion is also reduced in patients with CRF,
which appears to be due to metabolic acidosis, elevated levels of parathyroid hormone, and
decreased level of vitamin D.It should be noted that despite the decreased insulin secretion and
impaired tissue sensitivity to insulin that occurs in patients with CRF, most nondiabetic CRF
patients do not have hyperglycemia unless they are genetically predisposed.In advanced stages of
CRF, when the glomerular filtration rate (GFR) become less than 15-20 cc/min, degradation and
renal clearance of insulin decreases, which is clinically important in the treatment of patients
INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
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with diabetes. Although insulin resistance increases the insulin requirement, decreased insulin
degradation reduces the need for administration of insulin in diabetic patients with advanced
CRF or even resolves it in patients with type 2 diabetes. This may increase the risk of
hypoglycemia. Renal replacement therapy, hemodialysis, and peritoneal dialysis relatively
resolve this problem in most patients and based on the amount of clinical improvement, the
insulin requirements change. Increased appetite and food intake resulting from the replacement
therapy and alleviation of uremic symptoms also change insulin requirements. Patients with
diabetes should be screened on an annual basis for nephropathy. In individuals with type 1
diabetes, screening for nephropathy should start 5 years after diagnosis of diabetes since the
onset of diabetes itself is usually known. It typically takes about 5 years for microvascular
complications to develop. In patients with type 2 diabetes, screening should begin at initial
diagnosis since the exact onset of diabetes is often unknown.
Diabetic nephropathy can be detected by the measurement of urine albumin or serum
creatinine, and both tests should be performed at minimum annually; those with abnormal levels
should have repeat tests done sooner. The first stage of nephropathy is usually the onset of
elevated urine albumin which predicts the development of CKD and a gradual decline in
glomerular filtration rate (GFR). Some individuals with CKD, however, do not develop elevated
urine albumin initially. It is therefore important that individuals have both blood and urine
screening tests performed. Using both modalities allows for identification of more cases of
nephropathy than using either test alone.The urine albumin to creatinine ratio can be measured
on a spot or timed urine collection such as 4 or 24 h. Microalbuminuria is defined as >30 mg/g
creatinine or 30 mg per 24 h. Clinical-or macro-albuminuria is defined as >300 mg/g creatinine
or 300 mg per 24 h. An abnormal value should be confirmed on at least one additional urine
specimen over a 6 month period. Recently, the terms “moderately increased” and “severely
increased” albuminuria have been introduced to replace the terms “microalbuminuria” and
“macroalbuminuria”. Increased albumin excretion is not only a marker for early diabetic kidney
disease but also for increased risk for macrovascular disease. Other causes of elevated urine
protein should be considered and avoided such as infection, strenuous exercise, hypertension,
heart failure and hematuria. The serum creatinine should be used to estimate GFR and thus, the
level of CKD.One must also consider that the development of nephropathy may not be related to
the diabetes itself. In patients with type 1 diabetes, the onset of retinopathy usually precedes the
development of nephropathy. An individual who present with nephropathy but no retinopathy
should have an evaluation for other causes. Referral to a nephrologist should be utilized to
establish the cause of nephropathy when this is uncertain. Nephrologists are also vital to assist
management of complications of advancing kidney disease, such as difficult to control
hypertension, hyperkalemia and rapid progression.
Diabetic nephropathy is characterized by glomerular damage due to prolonged high blood
sugar levels. This leads to increased glomerular filtration pressure and ultimately kidney damage.
Monitoring and managing blood glucose levels are essential to prevent further deterioration of
kidney function.
Geodialysis overview.
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Geodialysis, or peritoneal dialysis, is often used for patients with end-stage renal disease (ESRD).
It utilizes the peritoneal cavity as a membrane for waste removal. This method can be beneficial
for diabetic patients due to various reasons:
- Better Glycemic Control: Peritoneal dialysis can allow for more flexible dietary management.
- Reduced Insulin Requirements: The modality can potentially lower the need for insulin.
Key features in management.
1. Blood glucose monitoring
- Regular monitoring of blood glucose levels is critical.
- Aim for tight glycemic control to reduce the risk of further kidney damage.
2. Dietary modifications
- A diet low in carbohydrates and high in fiber may help manage blood sugar levels.
- Adequate protein intake is crucial for dialysis patients, but excess protein should be avoided
to prevent additional kidney stress.
3. Medications.
- Use of medications like ACE inhibitors and angiotensin II receptor blockers can help in
kidney protection.
- Adjustments may be necessary based on kidney function and dialysis regimen.
4. Regular assessments.
- Routine check-ups including kidney function tests, HbA1c monitoring, and foot exams are
important.
- Assess for signs of cardiovascular disease, which is prevalent in diabetic patients.
5. Patient education.
- Educating patients on managing their diabetes and understanding the dialysis process is vital
for compliance and outcomes.
- Emphasizing the importance of adhering to prescribed treatments can improve prognosis.
Conclusion.Managing renal failure in diabetic patients on geodialysis requires a tailored
approach focusing on glycemic control, dietary considerations, and pharmacological
management. Regular monitoring and patient education play key roles in optimizing health
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outcomes in this vulnerable population. By addressing these features, healthcare providers can
better support patients with diabetes mellitus undergoing geodialysis.
References:
1. Abdiev K.M, et al. Comparative evaluatation of new treatments for immune
thrombocytopenia // Nat.Volatiles & Essent.Oils, 2021; 8(5):10160 –10166.
2. Kattabek Maxmatovich Abdiyev, Erkin San’atovich Toirov, K,J,Artikova. Состояние
желудка и двенадцатиперстной кишки при ревматоидном артрите. 2005 Журнал
Вестник врача общей практики Том 36 Номер 4 Страницы 5-7
3. Madasheva, А. G., Dadajonova, U. D, Abdiyev, К. М., Mamatkulova, F. X., & Mahmudova,
А. D. Динамика электронейромиографических показателей и эффективность
электрической стимуляции мышц у больных гемофилией с мышечными атрофиями.
Достижения науки и образования, (10 (51)), (2019). 26-30.
4. Madasheva, А. G., & Mahmudova, А. D. (2021). Биохимические показатели у больных
гемофилией с мышечными патологиями до и после лечения. Форум молодых ученых,
(4 (56)), 233-238.
5. Gazkhanovna, M. A., Makhmatovich, A. K., & Utkirovich, D. U. (2022). Clinical efficacy of
extracorporeal and intravascular hemocorrection methods in psoriasis. ACADEMICIA: An
International Multidisciplinary Research Journal, 12(2), 313-318.
6. Madasheva, А. G. (2022). Коррекция диффузной алопеции при железодефицитной
анемии. Science and Education, 3(12), 231-236.
