Clinical outcome and risk factors for mortality in Chinese patients with diabetes on peritoneal dialysis: A 5-year clinical cohort study

AimsWe evaluated clinical outcome and risk factors affecting survival in patients with diabetes on continuous ambulatory peritoneal dialysis (CAPD) in Southern China.MethodsThis longitudinal cohort study enrolled all incident patients who used CAPD as their first renal replacement therapy modality in our center from January 2006 to December 2009 and who were followed until December 2011. Clinical outcomes were compared and risk factors for mortality in patients with diabetes were analyzed.ResultsOf 809 incident CAPD patients, 189 (23.4%) had diabetes. Death-censored technique survival showed no significant difference between patients with and without diabetes (p = 0.271). The 1-, 2-, 3- and 5-year patient survival rates were 90%, 72%, 63% and 36% in patients with diabetes and 95%, 92%, 87% and 73% in patients without diabetes, respectively (p = 0.000). Presence of cardiovascular disease (CVD) [hazard ratio (HR) 2.130, 95% confidence interval (CI) 1.199–3.786, p = 0.010], advanced age (HR 1.042, 95% CI 1.008–1.078, p = 0.014), higher glycated hemoglobin (HR 1.309, 95% CI 1.045–1.640, p = 0.019), lower hemoglobin (HR 0.978, 95% CI 0.964–0.992, p = 0.003) and lower serum albumin (HR 0.924, 95% CI 0.876–0.976, p = 0.004) at the initiation of CAPD were independent risk factors of mortality in CAPD patients with diabetes.ConclusionsTechnique survival in CAPD patients with diabetes was similar to those without diabetes. Although patients with diabetes had higher risk of mortality, the patient survival in our study seems to be improved compared with most other reports. Older age, presence of CVD, hyperglycemia, anemia and hypoalbuminemia at the commencement of CAPD affected survival in patients with diabetes.