Document Detail


Pre-dialysis glycemic control is an independent predictor of mortality in type II diabetic patients on continuous ambulatory peritoneal dialysis.
MedLine Citation:
PMID:  10406515     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the impact of pre-dialysis glycemic control on clinical outcomes for type II diabetic patients on continuous ambulatory peritoneal dialysis (CAPD). MATERIALS AND METHODS: One hundred and one type II diabetic patients receiving CAPD for at least 3 months were enrolled in a single institute. The patients were classified into two groups according to status of glycemic control. In the good glycemic control group, more than 50% of blood glucose determinations were within 3.3-11.0 mmol/L and glycosylated hemoglobin (HbA1C) levels were within 5%-10% at all times. In the poor glycemic control group, less than 50% of blood glucose determinations were within 3.3-11.0 mmol/L, or HbA1C levels were above 10% at least 6 months before peritoneal dialysis was started. In addition to glycemic control status, pre-dialysis serum albumin, cholesterol levels, residual renal function, peritoneal membrane function, and modes of glycemic control were also recorded. RESULTS: The patients with good glycemic control had significantly better survival than those with poor glycemic control (p < 0.01). There was no significant difference in pre-dialysis morbidity between two groups. No significant differences were observed in patient survival between patients with serum albumin above 30 g/L and those with serum albumin under 30 g/L; between those with cholesterol levels above or below 5.2 mmol/L; and between those with different peritoneal membrane solute transport characteristics as evaluated by a peritoneal equilibration test (PET). Furthermore, there was no significant difference in survival between patients who controlled blood sugar by diet and those who controlled it by insulin. Cardiovascular disease and infection are the major causes of death in both groups. Although good glycemic control predicts better survival, it does not change the pattern of mortality in diabetic patients maintained on CAPD. CONCLUSIONS: Glycemic control before starting dialysis is a predictor of survival for type II diabetic patients on CAPD. Patients with poor glycemic control predialysis are associated with increased morbidity and shortened survival.
Authors:
M S Wu; C C Yu; C H Wu; J Y Haung; M L Leu; C C Huang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  19 Suppl 2     ISSN:  0896-8608     ISO Abbreviation:  Perit Dial Int     Publication Date:  1999  
Date Detail:
Created Date:  1999-08-24     Completed Date:  1999-08-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  S179-83     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Chang-Gung Memorial Hospital, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Blood Glucose / analysis*
Cause of Death
Diabetes Mellitus, Type 2 / blood*,  mortality*,  therapy
Diabetic Nephropathies / therapy*
Female
Hemoglobin A, Glycosylated / analysis
Humans
Male
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory*
Retrospective Studies
Risk Factors
Serum Albumin / analysis
Survival Rate
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Serum Albumin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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