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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
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.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91674
DOI
10.1371/journal.pone.0030072
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
강신욱(Kang, Shin Wook) ; 김승준(Kim, Seung Jun) ; 박정탁(Park, Jung Tak) ; 신동호(Shin, Dong Ho) ; 오형중(Oh, Hyung Jung) ; 유동은(Yoo, Dong Eun) ; 유태현(Yoo, Tae Hyun) ; 이미정(Lee, Mi Jung) ; 최규헌(Choi, Kyu Hun) ; 한승혁(Han, Seung Hyeok)
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