Abstract
【Abstract】 Objective To study the long-term patient and technique survival and analyze the predictors of mortality in diabetic patients receiving peritoneal dialysis (PD). Methods This study included all end-stage renal disease (ESRD) patients who started on PD between 1 January 2000 and 31 December 2009 in Renji Hospital, Shanghai Jiao Tong University school of Medicine. Survival probabilities were studied with Kaplan-Meier method and multivariate Cox proportional hazards models were used to assess the predictors of survival. Results A total of 598 patients were enrolled. Among them, 130 patients (21.7%) were diabetics. Compared with non-diabetic patients, diabetics were older (63.7±13.3 vs 52.9±17.0, P<0.001), had more instances of cardiovascular disease (CVD) (31.0% vs 13.6%,P<0.001), lower serum albumin (32.4±5.7 vs 35.1±5.3,P<0.001) and normalized protein catabolic rate (nPCR) ( 0.87±0.26 vs 0.96±0.22,P <0.001). The 1-,2-,3- and 5-year patient survival rates were 86.1%, 73.5%, 58.2% and 50.9% in diabetics, respectively. Patient survival was significantly lower in diabetic patients when compared to non-diabetics (Log rank 25.40, P<0.001). Stratified analysis showed that diabetic patients had significant inferior survival than non-diabetics in patients younger than 65 yrs (Log rank 13.36,P <0.001), while patient survival was similar in diabetics and non-diabetics when they were aged 65 or older (Log rank 0.723, P =0.395). The technique survival and peritonitis-free survival were similar in both patients (P>0.05). Advanced age (HR 1.05 95%CI 1.00-1.08, P =0.019), lower serum albumin (HR 0.91 95%CI 0.83-1.00, P=0.041) and CVD comorbidity (HR 4.49 95%CI 1.94-10.41, P<0.001) were the significant factors that independently predicted outcome in diabetic patients on PD. Conclusions Long-term patient survival for diabetic PD patients was worse than that of non-diabetics, but technique survival and peritonitis-free survival were comparable. PD remains a viable modality of renal replacement therapy for diabetic ESRD patients. Advanced age, lower serum albumin and CVD comorbidity were predictors of mortality in diabetic PD patients.
Cite this article
Download Citations
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}