Good glycemic control is associated with better survival in diabetic patients on peritoneal dialysis: A prospective observational study

Dong Eun Yoo, Jung Tak Park, Hyung Jung Oh, Seung Jun Kim, Mi Jung Lee, Dong Ho Shin, Seung Hyeok Han, Tae Hyun Yoo, Kyu Hun Choi, Shin Wook Kang

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: The effect of glycemic control after starting peritoneal dialysis (PD) on the survival of diabetic PD patients has largely been unexplored, especially in Asian population. Methods: We conducted a prospective observational study, in which 140 incident PD patients with diabetes were recruited. Patients were divided into tertiles according to the means of quarterly HbA1C levels measured during the first year after starting PD. We examined the association between HbA1C and all-cause mortality using Cox proportional hazards models. Results: The mean age was 58.7 years, 59.3% were male, and the mean follow-up duration was 3.5 years (range 0.4-9.5 years). The mean HbA1C levels were 6.3%, 7.1%, and 8.5% in the 1 st, 2 nd, and 3 rd tertiles, respectively. Compared to the 1 st tertile, the all-cause mortality rates were higher in the 2 nd [hazard ratio (HR), 4.16; 95% confidence interval (CI), 0.91-18.94; p = 0.065] and significantly higher in the 3 rd (HR, 13.16; 95% CI, 2.67-64.92; p = 0.002) tertiles (p for trend = 0.005), after adjusting for confounding factors. Cardiovascular mortality, however, did not differ significantly among the tertiles (p for trend = 0.682). In contrast, non-cardiovascular deaths, most of which were caused by infection, were more frequent in the 2 nd (HR, 7.67; 95% CI, 0.68-86.37; p = 0.099) and the 3 rd (HR, 51.24; 95% CI, 3.85-681.35; p = 0.003) tertiles than the 1 st tertile (p for trend = 0.007). Conclusions: Poor glycemic control is associated with high mortality rates in diabetic PD patients, suggesting that better glycemic control may improve the outcomes of these patients.

Original languageEnglish
Article numbere30072
JournalPloS one
Volume7
Issue number1
DOIs
Publication statusPublished - 2012 Jan 23

Fingerprint

glycemic control
Dialysis
Peritoneal Dialysis
observational studies
dialysis
Observational Studies
Hazards
Prospective Studies
confidence interval
Survival
Confidence Intervals
Mortality
Medical problems
Proportional Hazards Models
diabetes
death
duration
Infection
infection
Population

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Yoo, Dong Eun ; Park, Jung Tak ; Oh, Hyung Jung ; Kim, Seung Jun ; Lee, Mi Jung ; Shin, Dong Ho ; Han, Seung Hyeok ; Yoo, Tae Hyun ; Choi, Kyu Hun ; Kang, Shin Wook. / Good glycemic control is associated with better survival in diabetic patients on peritoneal dialysis : A prospective observational study. In: PloS one. 2012 ; Vol. 7, No. 1.
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title = "Good glycemic control is associated with better survival in diabetic patients on peritoneal dialysis: A prospective observational study",
abstract = "Background: The effect of glycemic control after starting peritoneal dialysis (PD) on the survival of diabetic PD patients has largely been unexplored, especially in Asian population. Methods: We conducted a prospective observational study, in which 140 incident PD patients with diabetes were recruited. Patients were divided into tertiles according to the means of quarterly HbA1C levels measured during the first year after starting PD. We examined the association between HbA1C and all-cause mortality using Cox proportional hazards models. Results: The mean age was 58.7 years, 59.3{\%} were male, and the mean follow-up duration was 3.5 years (range 0.4-9.5 years). The mean HbA1C levels were 6.3{\%}, 7.1{\%}, and 8.5{\%} in the 1 st, 2 nd, and 3 rd tertiles, respectively. Compared to the 1 st tertile, the all-cause mortality rates were higher in the 2 nd [hazard ratio (HR), 4.16; 95{\%} confidence interval (CI), 0.91-18.94; p = 0.065] and significantly higher in the 3 rd (HR, 13.16; 95{\%} CI, 2.67-64.92; p = 0.002) tertiles (p for trend = 0.005), after adjusting for confounding factors. Cardiovascular mortality, however, did not differ significantly among the tertiles (p for trend = 0.682). In contrast, non-cardiovascular deaths, most of which were caused by infection, were more frequent in the 2 nd (HR, 7.67; 95{\%} CI, 0.68-86.37; p = 0.099) and the 3 rd (HR, 51.24; 95{\%} CI, 3.85-681.35; p = 0.003) tertiles than the 1 st tertile (p for trend = 0.007). Conclusions: Poor glycemic control is associated with high mortality rates in diabetic PD patients, suggesting that better glycemic control may improve the outcomes of these patients.",
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Good glycemic control is associated with better survival in diabetic patients on peritoneal dialysis : A prospective observational study. / Yoo, Dong Eun; Park, Jung Tak; Oh, Hyung Jung; Kim, Seung Jun; Lee, Mi Jung; Shin, Dong Ho; Han, Seung Hyeok; Yoo, Tae Hyun; Choi, Kyu Hun; Kang, Shin Wook.

In: PloS one, Vol. 7, No. 1, e30072, 23.01.2012.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Good glycemic control is associated with better survival in diabetic patients on peritoneal dialysis

T2 - A prospective observational study

AU - Yoo, Dong Eun

AU - Park, Jung Tak

AU - Oh, Hyung Jung

AU - Kim, Seung Jun

AU - Lee, Mi Jung

AU - Shin, Dong Ho

AU - Han, Seung Hyeok

AU - Yoo, Tae Hyun

AU - Choi, Kyu Hun

AU - Kang, Shin Wook

PY - 2012/1/23

Y1 - 2012/1/23

N2 - Background: The effect of glycemic control after starting peritoneal dialysis (PD) on the survival of diabetic PD patients has largely been unexplored, especially in Asian population. Methods: We conducted a prospective observational study, in which 140 incident PD patients with diabetes were recruited. Patients were divided into tertiles according to the means of quarterly HbA1C levels measured during the first year after starting PD. We examined the association between HbA1C and all-cause mortality using Cox proportional hazards models. Results: The mean age was 58.7 years, 59.3% were male, and the mean follow-up duration was 3.5 years (range 0.4-9.5 years). The mean HbA1C levels were 6.3%, 7.1%, and 8.5% in the 1 st, 2 nd, and 3 rd tertiles, respectively. Compared to the 1 st tertile, the all-cause mortality rates were higher in the 2 nd [hazard ratio (HR), 4.16; 95% confidence interval (CI), 0.91-18.94; p = 0.065] and significantly higher in the 3 rd (HR, 13.16; 95% CI, 2.67-64.92; p = 0.002) tertiles (p for trend = 0.005), after adjusting for confounding factors. Cardiovascular mortality, however, did not differ significantly among the tertiles (p for trend = 0.682). In contrast, non-cardiovascular deaths, most of which were caused by infection, were more frequent in the 2 nd (HR, 7.67; 95% CI, 0.68-86.37; p = 0.099) and the 3 rd (HR, 51.24; 95% CI, 3.85-681.35; p = 0.003) tertiles than the 1 st tertile (p for trend = 0.007). Conclusions: Poor glycemic control is associated with high mortality rates in diabetic PD patients, suggesting that better glycemic control may improve the outcomes of these patients.

AB - Background: The effect of glycemic control after starting peritoneal dialysis (PD) on the survival of diabetic PD patients has largely been unexplored, especially in Asian population. Methods: We conducted a prospective observational study, in which 140 incident PD patients with diabetes were recruited. Patients were divided into tertiles according to the means of quarterly HbA1C levels measured during the first year after starting PD. We examined the association between HbA1C and all-cause mortality using Cox proportional hazards models. Results: The mean age was 58.7 years, 59.3% were male, and the mean follow-up duration was 3.5 years (range 0.4-9.5 years). The mean HbA1C levels were 6.3%, 7.1%, and 8.5% in the 1 st, 2 nd, and 3 rd tertiles, respectively. Compared to the 1 st tertile, the all-cause mortality rates were higher in the 2 nd [hazard ratio (HR), 4.16; 95% confidence interval (CI), 0.91-18.94; p = 0.065] and significantly higher in the 3 rd (HR, 13.16; 95% CI, 2.67-64.92; p = 0.002) tertiles (p for trend = 0.005), after adjusting for confounding factors. Cardiovascular mortality, however, did not differ significantly among the tertiles (p for trend = 0.682). In contrast, non-cardiovascular deaths, most of which were caused by infection, were more frequent in the 2 nd (HR, 7.67; 95% CI, 0.68-86.37; p = 0.099) and the 3 rd (HR, 51.24; 95% CI, 3.85-681.35; p = 0.003) tertiles than the 1 st tertile (p for trend = 0.007). Conclusions: Poor glycemic control is associated with high mortality rates in diabetic PD patients, suggesting that better glycemic control may improve the outcomes of these patients.

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