Work

Sp511impact of Diabetic Kidney Disease on Clinical Outcome in Patients on Continuous Ambulatory Peritoneal Dialysis

Year: 2018

Type: article

Abstract: INTRODUCTION AND AIMS: Diabetic kidney disease (DKD) is the second commonest cause of end stage of renal disease, accounting for almost a quarter of the dialysis population in China; however, studies on DKD vs non-DKD patients undergoing peritoneal dialysis (PD) are scarce. The aim of this study is to investigate basic clinical features, identify risk factors and compare clinical outcomes and survival rates between DKD and non-DKD patients in a center in northern China. METHODS: In a single-center cohort study of all incident adult patients who used PD as their first renal replacement therapy modality during > 90 day in north China center from June 1, 2012 to June 30, 2015, we enrolled 278 incident stable PD patients ranging in age from 19 to 91 years among whom 99 (55%) patients had DKD. Clinical and biochemical characteristics and detailed data on peritonitis episodes, hospitalizations, and causes for cessation of PD were recorded. Patients were followed for median x months up to 5 years. RESULTS: Apart from higher blood glucose and white blood cell count (WBC), the only differences in blood biochemistry in DKD vs non-DKD were lower serum albumin, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and red blood cell distribution width (RDW). In competing risk analysis of DKD, age, sex, cardiovascular disease (CVD), body mass index (BMI), serum albumin and C-reactive protein (CRP), multivariable sub-hazard ratios (sHR) for death were for DKD vs non-DKD patients sHR 4.01 (95% confidence interval, 95%CI, 2.03-7.91), male vs female sHR 2.03 (95%CI 1.06-3.86) and 1 standard deviation higher age sHR 3.06 (95%CI 2.02-4.64), while associations with CVD, BMI, and serum albumin and CRP were not significant. Time to first peritonitis was significantly in patients with CVD vs non-CVD but did not differ between DKD vs non-DKD. CONCLUSIONS: PD patients with DKD had higher WBC and lower serum albumin, MCV, MCHC and RDW. First episode of peritonitis was shorter in patients with CVD but did not differ according to DKD status. High age, male sex, and DKD are independent predictors of mortality in PD patients.

Source: Nephrology Dialysis Transplantation

DOI: 10.1093/ndt/gfy104.sp511

Authors: Shouci Hu, Ming Pei, Bo Yang, Hongtao Yang

Institutions: Tianjin University of Traditional Chinese Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine

Language: English

Topic: Dialysis and Renal Disease Management

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

OpenAlex ID: W2803968534