Comparison of Long-Term Outcomes between Peritoneal Dialysis Patients with Diabetes as a Primary Renal Disease or as a Comorbid Condition

• Published in: PloS one 2015-05, Vol.10 (5), p.e0126549-e0126549
• Main Authors: Lei, Yutian, Xiong, Yifan, Zhang, Lin, Yan, Hao, Li, Zhenyuan, Cao, Liou, Huang, Jiaying, Gu, Aiping, Ni, Zhaohui, Qian, Jiaqi, Fang, Wei
• Format: Article
• Language: English
• Subjects: Aged; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Comorbidity; Comparative analysis; Development and progression; Diabetes; Diabetes mellitus; Diabetic nephropathies; Diabetic Nephropathies - metabolism; Diabetic Nephropathies - pathology; Diabetic Nephropathies - therapy; Diabetic nephropathy; Diabetic retinopathy; Dialysis; Female; Hospitals; Humans; Kaplan-Meier Estimate; Kidney diseases; Kidney Failure, Chronic - metabolism; Kidney Failure, Chronic - pathology; Kidney Failure, Chronic - therapy; Kidney transplantation; Laboratories; Male; Medicine; Middle Aged; Mortality; Multivariate Analysis; Nephrology; Nephropathy; Patient outcomes; Patients; Peritoneal dialysis; Peritoneal Dialysis - adverse effects; Peritoneum; Peritonitis; Proportional Hazards Models; Proteins; Regression analysis; Regression models; Retrospective Studies; Survival; Urine
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0126549

To investigate the long-term outcomes of peritoneal dialysis (PD) patients with diabetes as primary renal disease and patients with diabetes as a comorbid condition. All diabetic patients who commenced PD between January 1, 1995 and June 30, 2012 at Ren Ji Hospital, China were included. Patients were divided into diabetic nephropathy group (DN group) and non-diabetic nephropathy group (NDN group) according to their diagnosis of primary renal disease at the initiation of PD. They were followed until death, cessation of PD, transferred to other centers or to the end of study (June 30, 2013). Outcomes were analyzed by Kaplan-Meier method and Cox regression models. A total of 163 diabetic patients were enrolled in the study, including 121 (74.2%) in DN group and 42 (25.8%) in NDN group. The 1-, 2-, 3- and 5-year patient survival rates were 89%, 78%, 66% and 51% for DN group, and 85%, 63%, 53% and 25% for NDN group, respectively. Kaplan-Meier analysis showed that patients in NDN group had a worse patient survival compared with DN group (log rank 4.830, P=0.028). Patients in NDN group had a marginally shorter peritonitis-free period (log rank 3.297, P=0.069), however, there was no significant difference in technique survival (log rank 0.040, P=0.841). Multivariate Cox regression analysis showed that older age (HR 1.047, 95% CI 1.022-1.073, p