Abstract: TH-PO335
Impact of Glycemic Control on Technique Failure in Incident Peritoneal Dialysis with Diabetes: Focusing on Volume Overload
Session Information
- Home Dialysis - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Kim, Dong Eon, Pusan National University Hospital, Busan, Korea (the Republic of)
- Kim, Hyo Jin, Pusan National University Hospital, Busan, Korea (the Republic of)
- Seong, Eun Young, Pusan National University Hospital, Busan, Korea (the Republic of)
- Song, Sang Heon, Pusan National University Hospital, Busan, Korea (the Republic of)
Background
To date, diabetes mellitus (DM) has been regarded as a risk factor for ultrafiltration failure in peritoneal dialysis (PD). This study is aim to delineate whether glycemic control could contribute to the technique failure in PD patients with DM, especially in terms of volume overload.
Methods
We retrospectively analyzed data from 84 incident PD patients with DM. The study population consisted of 71 males and 13 females, with mean age 51.1 ±1.3 years. Median follow-up duration was 34.5 ± 2.4 months. We divided the patients into two groups based on the time-average HbA1c values : HbA1c 8.0%≤ (n=17) and HbA1c 8.0%>(n=67). We used multivariate Cox proportional regression models to assess the relationship between the degree of glycemic control and the occurrence of volume overload-associated technique failure.
Results
Multivariate Cox regression analysis revealed that patients with a HbA1c level 8.0≤ had a significantly higher risk of volume overload associated technique failure (HR 3.741, 95%CI 1.166-11.908, P=0.026) compared to counterparts particularly within the first 2-years (HR 6.760, 95%CI 1.413-32.331, P=0.017). Additionally, hypertension was found to be significantly associated with an increased risk of volume overload-associated technique failure (HR 10.021, 95%CI 1.236-81.260, P=0.033).
Conclusion
Inadequate glycemic control (HbA1c 8.0≤) particularly during the first 2-years, and hypertension were found to be related with a volume overload-associated technique failure in DM patients undergoing PD.
Cox Regression Analysis for volume overload-associated technique failure
| Univariate model | Multivariate model | |||||
| variable | HR | 95% CI | p | HR | 95% CI | p |
| Age (60<) | 0.309 | 0.040-2.366 | 0.258 | 0.333 | 0.039-2.812 | 0.336 |
| Gender (male) | 0.888 | 0.278-2.840 | 0.842 | 1.215 | 0.301-4.904 | 0.784 |
| Time average A1c 8.0≤ | 3.160 | 1.096-9.113 | 0.033 | 3.741 | 1.166-11.908 | 0.026 |
| PD modality (APD vs. CAPD) | 0.869 | 0.301-2.506 | 0.795 | 0.496 | 0.127-1.931 | 0.312 |
| Exposure to High concentrate glucose | 0.557 | 0.184-1.681 | 0.583 | 0.504 | 0.108-2.357 | 0.658 |
| Use of Icodextrin | 1.012 | 0.339-3.024 | 0.983 | 1.179 | 0.348-3.997 | 0.881 |
| Hypertension | 6.255 | 0.917-47.885 | 0.077 | 0.517 | 0.119-1.668 | 0.377 |
| Cardiovascular disease | 0.389 | 0.121-1.252 | 0.113 | 0.430 | 0.111-1.668 | 0.222 |
Funding
- Veterans Affairs Support