Survival Rates in Patients with Diabetes on Peritoneal Dialysis in China

Abstract

Objective: To compare overall survival and technical survival in diabetic mellitus (DM) and non-DM (N-DM) Chinese patients undergoing peritoneal dialysis (PD), and to discuss the factors involved. Methods: Clinical data were analyzed for all adult patients (age >18 years) with chronic renal failure who had commenced PD between 2006 and 2010 in a single Chinese center. Results: Compared to the N-DM group, the DM group was older (64.5 ± 11.9 years vs. 59.2 ± 15.2 years, p = 0.023), with a higher body mass index (BMI) (25.2 ± 3.5 kg/m2 vs. 23.2 ± 3.5 kg/m2, p = 0.001), a higher estimated glomerular filtration rate (eGFR) (10.4 ± 4.7 mL/min/1.73 m2 vs. 6.9 ± 2.9 mL/min/1.73 m2, p = 0.000), and lower intact parathyroid levels (81.35 pg/mL vs. 186.3 pg/mL, p = 0.003). During the average 23.8-month follow-up period, the 1-, 2-, and 3-year survival rates of the DM group were 95.8%, 69.2%, and 60%, respectively. The 1-, 2-, and 3-year survival rates of the N-DM group were 87.2%, 76.5%, and 66.7%, respectively. There was no significant difference in survival between the groups. The 1-, 2-, and 3-year technical survival rates of the DM group were 93.8%, 69.2% and 60%, respectively. The 1-, 2-, and 3-year technical survival rates of the N-DM group were 84.6%, 72.5% and 63.3%, respectively. There was no significant difference in technical survival between the groups. Within the DM group, the only factor predictive for both overall survival (p = 0.015) and technical survival (p = 0.009) was the initial BMI, and both survival outcomes in DM patients with a BMI greater than 24 were higher than those observed with a BMI less than 24. Conclusions: In the first 3 years of PD, DM and N-DM patients have similar survival rates. Chinese DM patients with a higher BMI undergoing PD appear to have higher survival rates than those with a lower BMI.