Diabetic patients could do as well as non-diabetic patients without inflammation on peritoneal dialysis.
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 in...
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doaj-72f3699ff3424b07b9eb1ca6f28b50982020-11-24T21:45:07ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01811e8048610.1371/journal.pone.0080486Diabetic patients could do as well as non-diabetic patients without inflammation on peritoneal dialysis.Rong XuQingFeng HanTongYing ZhuYeping RenJiangHua ChenHuiPing ZhaoMengHua ChenJie DongYue WangChuanMing HaoRui ZhangXiaohui ZhangMei WangNa TianHaiYan WangBACKGROUND: 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 regression 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.http://europepmc.org/articles/PMC3832492?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rong Xu QingFeng Han TongYing Zhu Yeping Ren JiangHua Chen HuiPing Zhao MengHua Chen Jie Dong Yue Wang ChuanMing Hao Rui Zhang Xiaohui Zhang Mei Wang Na Tian HaiYan Wang |
spellingShingle |
Rong Xu QingFeng Han TongYing Zhu Yeping Ren JiangHua Chen HuiPing Zhao MengHua Chen Jie Dong Yue Wang ChuanMing Hao Rui Zhang Xiaohui Zhang Mei Wang Na Tian HaiYan Wang Diabetic patients could do as well as non-diabetic patients without inflammation on peritoneal dialysis. PLoS ONE |
author_facet |
Rong Xu QingFeng Han TongYing Zhu Yeping Ren JiangHua Chen HuiPing Zhao MengHua Chen Jie Dong Yue Wang ChuanMing Hao Rui Zhang Xiaohui Zhang Mei Wang Na Tian HaiYan Wang |
author_sort |
Rong Xu |
title |
Diabetic patients could do as well as non-diabetic patients without inflammation on peritoneal dialysis. |
title_short |
Diabetic patients could do as well as non-diabetic patients without inflammation on peritoneal dialysis. |
title_full |
Diabetic patients could do as well as non-diabetic patients without inflammation on peritoneal dialysis. |
title_fullStr |
Diabetic patients could do as well as non-diabetic patients without inflammation on peritoneal dialysis. |
title_full_unstemmed |
Diabetic patients could do as well as non-diabetic patients without inflammation on peritoneal dialysis. |
title_sort |
diabetic patients could do as well as non-diabetic patients without inflammation on peritoneal dialysis. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2013-01-01 |
description |
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 regression 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. |
url |
http://europepmc.org/articles/PMC3832492?pdf=render |
work_keys_str_mv |
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