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Predialysis factors related to prognosis in type 2 diabetic patients on chronic dialysis in Japan
Author(s) -
OKADA Tomonari,
NAKAO Toshiyuki,
MATSUMOTO Hiroshi,
HIDAKA Hirgmi,
YOSHINO Maki,
SHINO Tamami,
NAGAOKA Yume,
TAKEGUCHI Humihiro,
IWASAWA Hideaki,
TOMARU Ryo
Publication year - 2002
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1046/j.1440-1797.2002.00121.x
Subject(s) - medicine , dialysis , peritoneal dialysis , hazard ratio , proportional hazards model , univariate analysis , confidence interval , hemodialysis , diabetes mellitus , surgery , multivariate analysis , endocrinology
SUMMARY: We investigated to clarify the predialysis factors associated with prognosis in type 2 diabetic patients entering chronic dialysis. One hundred and twenty‐four type 2 diabetic patients who started chronic dialysis in our department between January 1992 and November 2000 were studied. the variables in the predialysis period and those at initiation of dialysis were collected and evaluated in association with prognosis after a mean follow up of 37 ± 23 months from initiation of dialysis by using Cox's proportional‐hazards model. the 1‐, 3‐, and 5‐year survival rates after initiating chronic dialysis were 92.7, 74.6, and 56.5%, respectively. During follow up, 40 patients died. Univariate analysis demonstrated that serum albumin (Alb) levels, haemoglobin A1c, and no preparation for permanent vascular or peritoneal access at initiation of dialysis were significantly associated with prognosis. In multivariate analysis, Alb levels (hazard ratio, 2.09, per decrease of 1 g/dL; confidence interval, 1.05–4.19), and age (1.54, per decrease of 10 years; 1.06–2.22) at initiation of dialysis remained significant predictors of mortality. In conclusion, Alb levels and age at initiation of dialysis are associated with prognosis in type 2 diabetic patients on chronic dialysis. It should be elucidated whether improvement of Alb levels at initiation of dialysis would have a favourable influence on survival after diabetic patients with renal failure are entered into chronic dialysis.