|Diabetic Patients Could Do As Well as Non-Diabetic Patients without Inflammation on Peritoneal Dialysis|
|Xu, Rong1; Han, QingFeng2; Zhu, TongYing3; Ren, Yeping4; Chen, JiangHua5; Zhao, HuiPing6; Chen, MengHua7; Dong, Jie1; Wang, Yue2; Hao, ChuanMing3; Zhang, Rui4; Zhang, Xiaohui5; Wang, Mei6; Tian, Na7; Wang, HaiYan1|
|WOS标题词||Science & Technology|
|研究领域[WOS]||Science & Technology - Other Topics|
|关键词[WOS]||RESIDUAL RENAL-FUNCTION ; C-REACTIVE PROTEIN ; GLYCATION END-PRODUCTS ; CORONARY-HEART-DISEASE ; LOW-GRADE INFLAMMATION ; ENDOTHELIAL DYSFUNCTION ; TECHNIQUE FAILURE ; BLOOD-PRESSURE ; RISK-FACTORS ; MORTALITY|
Background: Diabetic patients on peritoneal dialysis (PD) have lower survival and are more likely complicated with inflammation than their non-diabetic counterparts. Here, we explored the interaction effects between diabetes and inflammation on the survival of PD patients.
Methods: Overall, 2,264 incident patients were enrolled from a retrospective cohort study in China. Patients were grouped according to the baseline levels of high-sensitive C-reactive protein (hsCRP, <= 3 mg/L or >3 mg/L) or serum albumin (SA, >= 38 g/L or <38 g/L). Then, several multivariable adjusted stratified Cox regsion models were constructed for these groups to explore the predicted role of diabetes on all-cause or cardiovascular death under inflammatory or non-inflammatory conditions.
Results: Diabetics on PD were more likely to have inflammation than non-diabetics on PD, and they presented with elevated hsCRP (52.7% vs. 47.3%, P = 0.03) or decreased SA (77.9% vs. 62.7%, P < 0.001) levels. After stratification by size of center and controlling for confounding factors, diabetes was found to predict all-cause death in patients with hsCRP >3 mg/L or SA <38 g/L but not in patients with hsCRP <= 3 mg/L or SA >= 38 g/L. Similarly, the presence of diabetes was an indication of cardiovascular death in patients with hsCRP >3 mg/L or SA <38 g/L. However, if further adjusted by baseline cardiovascular disease, the predicted role of diabetes on death related to cardiovascular disease in patients with SA <38 g/L disappeared.
Conclusion: Diabetic patients could do as well as non-diabetic patients without inflammation on peritoneal dialysis. Active strategies should be implemented to improve inflammation status in diabetic patients on PD.
|资助机构||Baxer Clinical Research Award of Baxter Corp ; China and the ISN Research Award of ISN GO RP Committee|
|作者单位||1.Ningxia Med Univ, Gen Hosp, Dept Nephrol, Ningxia, Peoples R China|
2.Peking Univ, Hosp 1, Key Lab Renal Dis, Renal Div,Dept Med,Inst Nephrol,Minist Hlth,Minis, Beijing 100871, Peoples R China
3.Peking Univ, Hosp 3, Dept Nephrol, Beijing 100871, Peoples R China
4.Fudan Univ, Huashan Hosp, Dept Nephrol, Shanghai 200433, Peoples R China
5.Harbin Med Univ, Affiliated Hosp 2, Dept Nephrol, Heilongjiang, Peoples R China
6.Zhejiang Univ, Affiliated Hosp 1, Coll Med, Kidney Dis Ctr, Hangzhou 310003, Zhejiang, Peoples R China
7.Peking Univ, Dept Nephrol, Peoples Hosp, Beijing 100871, Peoples R China
|Xu, Rong,Han, QingFeng,Zhu, TongYing,et al. Diabetic Patients Could Do As Well as Non-Diabetic Patients without Inflammation on Peritoneal Dialysis[J]. PLOS ONE,2013,8(11).|
|APA||Xu, Rong.,Han, QingFeng.,Zhu, TongYing.,Ren, Yeping.,Chen, JiangHua.,...&Wang, HaiYan.(2013).Diabetic Patients Could Do As Well as Non-Diabetic Patients without Inflammation on Peritoneal Dialysis.PLOS ONE,8(11).|
|MLA||Xu, Rong,et al."Diabetic Patients Could Do As Well as Non-Diabetic Patients without Inflammation on Peritoneal Dialysis".PLOS ONE 8.11(2013).|