High peritoneal transport status was not associated with mortality in peritoneal dialysis patients with diabetes

• Published in: PloS one 2014-10, Vol.9 (10), p.e110445-e110445
• Main Authors: Huang, Naya, Chen, Jiehui, Fan, Li, Zhou, Qian, Xu, Qingdong, Xu, Ricong, Xiong, Liping, Yu, Xueqing, Mao, Haiping
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Analysis; Cardiovascular disease; Cardiovascular Diseases - mortality; Cardiovascular Diseases - pathology; Cardiovascular Diseases - therapy; Cohort Studies; Comorbidity; Confidence intervals; Continuity (mathematics); Diabetes; Diabetes mellitus; Diabetes Mellitus - mortality; Diabetes Mellitus - pathology; Diabetes Mellitus - therapy; Diabetics; Dialysis; Epidemiology; Female; Health risks; Hospitals; Humans; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - pathology; Kidney Failure, Chronic - therapy; Laboratories; Male; Medicine and Health Sciences; Middle Aged; Mortality; Nephrology; Patient outcomes; Patients; Peritoneal dialysis; Peritoneal Dialysis, Continuous Ambulatory - adverse effects; Peritoneum; Permeability; Proportional Hazards Models; Prospective Studies; Regression analysis; Regression models; Risk; Statistical analysis; Studies; Subgroups; Transport
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0110445

Continuous ambulatory peritoneal dialysis (CAPD) patients with diabetes are at increased risk of mortality and high peritoneal transporters appear to contribute to poor survival. However, little is known about the combined impacts of high peritoneal transporters and diabetes on mortality. This was a prospective observational cohort study. 776 incident CAPD patients were enrolled. Unadjusted and adjusted Cox proportional regression models were used to evaluate the association and interaction of peritoneal transport and diabetic status with mortality. In the entire cohort, high peritoneal transport status was associated with an increased risk of all-cause mortality in unadjusted model [hazard ratio (HR) 2.35, 95% confidence interval (CI) 1.30 to 4.25, P = 0.01], but this association was not significant in multivariable model. There was an interaction between peritoneal membrane transport status and diabetes (P = 0.028). Subgroup analyses showed that compared to low and low average transporters, high transporters was associated with a higher risk of all-cause mortality (adjusted HR 1.78, 95% CI 1.07 to 4.70, P = 0.04) in CAPD patients without diabetes, but not in those with diabetes (adjusted HR 0.79, 95%CI 0.33 to 1.89, P = 0.59). Results were similar when transport status was assessed as a continuous variable. The association between high peritoneal transport and all-cause mortality was likely to vary with diabetes status. High peritoneal transport was associated with an elevated risk of death among CAPD patients without diabetes, but not in those with diabetes.