Abstract
This study aimed to analyze the survival and the risk factors associated with mortality in diabetic CAPD patients in Southern China. This single-center prospective cohort study enrolled all incident CAPD patients from Jan 2006 to Dec 2009 and followed-up until Dec 2011.Survival in diabetic and non-diabetic CAPD patients and the risk factors on mortality in the diabetic CAPD subjects were evaluated. Among 841 incident CAPD subjects in this study, 193 patients (22.9%) were diabetes. The mean vintage of CAPD was 29.4±15.5 months. Shorter patient survival time was found in diabetic patients compared to that of non-diabetic ones ( p <0.01). The 1-, 3- and 5-year patient survival rates were 90%, 64% and 40% in diabetes and 95%, 88% and 75% in non-diabetes, respectively ( p <0.01). There was no significant difference in the death-censored technique survival time between diabetic and non-diabetic patients. The 1-, 3- and 5-year technique survival rates were 96%, 88% and 86% in diabetic, while 99%, 93% and 87% in non-diabetic patients, respectively. Diabetic CAPD patients that died during the follow-up period had older age(63.4±10.5 vs. 58.6±10.4 yrs, p <0.01), higher proportion of cardiovascular diseases (CVD)(64.9% vs. 47.1%, p <0.05), higher level of hsCRP [5.1(1.5∼11.7) vs. 1.8 (0.8∼7.2)] mg/L, p <0.01), but lower levels of haemoglobin (95.5±20.2 vs. 103.4±19.2g/L, p <0.01), serum albumin (33.7±4.0 vs. 35.3±4.9g/L, p <0.05) and 24h urine output [600(300∼813) vs. 800(500∼1100]ml/d, p <0.01) compared to the survivors. The presence of CVD, advanced age, higher glycosylated haemoglobin, lower hemoglobin and serum albumin at the initiation of PD were independent predictors of death in diabetic patients.It was concluded that survival of diabetic CAPD patients is not as good as that of non-diabetic patients in Southern Chinese patients, but better than those reported by other previous studies. Better management of modifiable risk factors such as hyperglycaemia, anemia and hypoalbuminemia may improve outcomes of diabetic PD patients.
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