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Clinical outcome of incident peritoneal dialysis patients with diabetic kidney disease

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Abstract

Background

Although peritoneal dialysis (PD) is becoming more widespread, PD among diabetic patients carries some concerns, such as worsened glycemic control due to constant exposure to glucose and operational errors due to diabetic complications. However, several technical advances could overcome these disadvantages. We, therefore, aimed to compare technical and patient survival between diabetic and non-diabetic PD patients.

Methods

We conducted a historical cohort study of 103 patients (mean age, 57 ± 16 years; 75 males, 32 diabetic patients) who started PD between January 2011 and January 2016. Kaplan–Meier survival analysis was used to compare technical and patient survivals between diabetic and non-diabetic patients. Multivariate Cox regression analysis was used to estimate the effects of the presence of diabetes on these outcomes.

Results

Technical and patient survivals did not differ significantly between groups (P = 0.62, P = 0.34, respectively). In addition, presence of diabetes affected neither technical nor patient survival in multivariate analysis (hazard ratio [HR], 1.31; 95% confidence interval [CI], 0.58–2.82 and HR 0.80; 95% CI 0.22–2.68, respectively).

Conclusions

Technical and patient survivals of diabetic PD patients were not inferior to those of non-diabetic PD patients. These results suggest that no hesitation is warranted in initiating PD for diabetic patients with end-stage renal disease.

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Acknowledgements

We gratefully acknowledge the support and participation of the patients in this study.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi Minato-ku, Tokyo, 1058461, Japan

    Kyoko Kishida, Yukio Maruyama, Kana Asari, Masatsugu Nakao, Nanae Matsuo, Yudo Tanno, Ichiro Ohkido, Masato Ikeda, Keitaro Yokoyama & Takashi Yokoo

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  1. Kyoko Kishida
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  2. Yukio Maruyama
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  3. Kana Asari
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  4. Masatsugu Nakao
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  6. Yudo Tanno
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  7. Ichiro Ohkido
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Corresponding author

Correspondence to Yukio Maruyama.

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Conflict of interest

Y.M. and M.I. have received scholarship funds from Baxter International, Inc. and Terumo Corporation. Y.T. has received research grants from Baxter International, Inc. No sources of funding had any direct involvement in the design or conduct of the study; the collection, management, analysis, or interpretation of data; or the preparation, review, or approval of the manuscript. No other authors have any conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number 29–286 (8902)) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was not required because of the non-intervention and retrospective chart review design. We provided all individual participants a means to opt out in this study.

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Kishida, K., Maruyama, Y., Asari, K. et al. Clinical outcome of incident peritoneal dialysis patients with diabetic kidney disease. Clin Exp Nephrol 23, 409–414 (2019). https://doi.org/10.1007/s10157-018-1646-3

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  • DOI: https://doi.org/10.1007/s10157-018-1646-3

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