Figure 143

Autonomic neuropathy. Autonomic neuropathy accompanies advanced diabetic nephropathy. While an unvarying R-R interval may have minimal clinical importance, diabetic cystopathy and reduced bowel motility, including gastroparesis, may seriously impede quality of life. Questioning to discern the presence of travel-limiting diarrhea, obstipation, and gastroparesis should be included in each initial evaluation of a diabetic kidney patient. (From Spallone and Menzinger [30]; with permission.)

Prevalent in majority, often silent Correlates with autonomic neuropathy Symptoms not linked to delayed emptying Management includes Prokinetic agents: cisapride, erythromycin, metoclopramide, domperidone Serotoninergic (5-HT-3) antagonists

0 0

Post a comment