Clinical Characteristics And Prognosis Of Diabetic Patients On Peritoneal Dialysis

Objective:To compare survivals of different dialysis models,analyze the clinical characteristics and risk factors of peritoneal dialysis patients with diabetes.Methods:A retrospective study of comparing survival between hemodialysis(HD)and peritoneal dialysis(PD)on diabetic patients in Zhejiang province from January 01,2008 to December 31,2016.And we investigated the clinical characteristics,outcomes and risk factors of peritoneal dialysis patients followed up from January 01,2007 to December 31,2018 in our center.According to complication,we divided into diabetic group(DM)and non-diabetic group(Non-DM).Results:The first part of our study was included in 8654 patients(HD 7527,PD 1127),the overall 1-,3-,5-,and 7-year survival rates for PD patients were 93.2%,77.6%,66.3%and 49.6%,respectively,whereas the patient survival rates for HD patients were 93.6%,80.0%,67.2% and 58.6%,respectively(Log rank P= 0.210).The second part of our study was included in 1906 patients(DM 312,Non-DM 1594).Age,diabetes,cardiovascular disease,Hb A1 c and albumin were influencing factors of PD patient survivals.Age,body mass index(BMI),albumin and peritonitis were influencing factors of PD patient technique survivals.Compared to Non-DM group,age,the proportion of male,the prevalence of cardiovascular disease,BMI were higher in DM group.Hb A1 c,serum sodium,low density lipoprotein,blood fat and glomerular filtration in DM group were higher than in Non-DM group,but albumin,parathyrin,serum phosphate and uric acid were lower than in Non-DM group.Residual renal function in DM group is better than in Non-DM group.Compared to Non-DM group,the proportion of death and change to hemodialysis was higher in DM group,but the proportion of change to renal transplant was lower.The prevalence of peritonitis was similar in two groups,only age was the risk factor of peritonitis in PD patients.Survivals and technique survivals in DM group were worse than in Non-DM group.The multivariate Cox regression analysis found that age and Hb A1 c were risk factors affecting survivals in diabetic PD patient,while peritonitis and high density lipoprotein were factors affecting technique survivals.Conclusions:There was no difference on survival rates between HD and PD patients with diabetes.The risk factors of survivals for diabetic PD patients were age and Hb A1 c.And peritonitis was the risk factor of technique survivals,whereas high density lipoprotein was the protective factor.