The impact of diabetes mellitus on peritoneal dialysis: the Turkey Multicenter Clinic Study. (March 2014)

• Record Type: Journal Article
• Authors: Ozener, Cetin; Arikan, Hakki; Karayaylali, Ibrahim; Utas, Cengiz; Bozfakioglu, Semra; Akpolat, Tekin; Ataman, Rezzan; Ersoy, Fevzi; Camsari, Taner; Yavuz, Mahmut; Akcicek, Fehmi; Yilmaz, M. Emin
• Is Part Of: Renal failure. Volume 36:Number 2(2014)
• Page Start: 149
• Page End: 153
• Publication Date: 2014-03
• Subjects: Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.3109/0886022X.2013.843275
• Languages: English
• ISSNs: 0886-022X

Abstract

<abstract> <title>Abstract</title> <p> <italic>Purpose</italic>: It is well established that diabetic peritoneal dialysis (PD) patients have a higher mortality rate than the other PD population. This study was designed to determine the overall predictors of survival and compared mortality and morbidity between diabetic and non-diabetic Turkish PD patients. <italic>Methods</italic>: We conducted a multicenter retrospective study with 915 PD patients [217 had diabetes mellitus (DM)]. Serum albumin, PTH, HbA1c, co-morbid diseases, dialysis adequacy (Kt/<italic>V</italic>), and peritoneal transport characteristics as well as peritonitis episodes and ultrafiltration failure during the follow-up period were recorded. <italic>Results</italic>: DM patients were older and had more co-morbidities than non-DM patients. Peritonitis rates were higher in DM patients (one episode per 35.9 patient months) compared to non-DM patients (one episode per 41.5 patient months) (<italic>p</italic> < 0.001). On Kaplan–Meier analysis, patient survival was significantly lower in DM patients with the 2-, 3- and 5-year patient survival rates of 90.8%, 87.8% and 78.2% in non-diabetics and 80.9%, 70.4% and 61.2% in diabetics, respectively. On Cox regression analysis, DM (HR 1.5, <italic>p =</italic> 0.022), age (HR 1.03, <italic>p</italic> < 0.001), baseline serum albumin (HR 0.39, <italic>p</italic> < 0.001), heart failure (HR 0.038, <italic>p =</italic> 0.038), peripheral artery disease (HR 1.83, <italic>p =</italic> 0.025) and amputation (HR 4.1, <italic>p =</italic> 0.009) at baseline were significant predictors of overall mortality. <italic>Conclusions</italic>: Patient survival is lower in diabetic compared to non-diabetic patients on PD. Peritonitis rates were also higher in diabetic PD patients. DM, older age, albumin level and cardiovascular co-morbidities are predictors of mortality</p> </abstract>