The association of glycemic control with patient survival and technique survival in incident diabetic peritoneal dialysis patients

Abstract

Abstract This study investigated the prognosis in incident diabetic peritoneal dialysis (PD) patients by glycemic control status. Compared to patients with time-averaged A1c values ≥9%, the risk of mortality was lower for patients with A1c of 6-6.9% [adjusted hazard ratio (HR) =0.39; 95% confidence interval (CI) =0.20, 0.78] and 7-7.9% (adjusted HR =0.47; 95% CI =0.24, 0.91). The risk of technique failure was lower for patients with time-averaged A1c of 6-6.9% (adjusted HR =0.55; 95% CI =0.33, 0.92) and 7-7.9% (adjusted HR =0.53; 95% CI =0.31, 0.90), compared to those with time-averaged A1c values ≥9%. Patients with baseline fasting serum glucose levels of 70-150 mg/dL had a lower risk of technique failure (adjusted HR =0.48; 95% CI =0.24, 0.97), compared to those with levels >300 mg/dL. Comparison based on time-averaged fasting serum glucose levels showed that patients with levels of of 70-150 mg/dL had a lower risk of mortality (adjusted HR =0.53; 95% CI =0.29, 0.99), compared to those with levels of 200-300 mg/dL. Diabetic PD patientswith time-averaged HbA1c 6-8% or fasting serum glucose levels of 70-150 mg/dL and time-averaged HbA1c 6-8% or baseline fasting serum glucose levels of 70-150 mg/dL had reduced risks of mortality and technique failure, respectively.