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

Authors
 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 
Citation
 PLoS One, Vol.7(1) : e30072, 2012 
Journal Title
 PLoS One 
ISSN
 1932-6203 
Issue Date
2012
MeSH
Aged ; Blood Glucose/analysis ; Blood Glucose/metabolism* ; Cause of Death ; Diabetes Mellitus, Type 2/blood* ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/mortality* ; Diabetes Mellitus, Type 2/therapy ; Diabetic Nephropathies/blood ; Diabetic Nephropathies/etiology ; Diabetic Nephropathies/mortality ; Diabetic Nephropathies/therapy ; Female ; Follow-Up Studies ; Glycated Hemoglobin A/analysis ; Humans ; Kidney Failure, Chronic/blood* ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/mortality* ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Observation ; Peritoneal Dialysis* ; Prospective Studies
Keywords
Aged ; Blood Glucose/analysis ; Blood Glucose/metabolism* ; Cause of Death ; Diabetes Mellitus, Type 2/blood* ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/mortality* ; Diabetes Mellitus, Type 2/therapy ; Diabetic Nephropathies/blood ; Diabetic Nephropathies/etiology ; Diabetic Nephropathies/mortality ; Diabetic Nephropathies/therapy ; Female ; Follow-Up Studies ; Glycated Hemoglobin A/analysis ; Humans ; Kidney Failure, Chronic/blood* ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/mortality* ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Observation ; Peritoneal Dialysis* ; Prospective Studies
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.
Files in This Item:
T201200480.pdf Download
DOI
22291903
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Seung Jun(김승준)
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Oh, Hyung Jung(오형중)
Yoo, Dong Eun(유동은)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Mi Jung(이미정)
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91674
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