Kishida Kyoko, Maruyama Yukio, Asari Kana, Nakao Masatsugu, Matsuo Nanae, Tanno Yudo, Ohkido Ichiro, Ikeda Masato, Yokoyama Keitaro, Yokoo Takashi
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi Minato-ku, Tokyo, 1058461, Japan.
Clin Exp Nephrol. 2019 Mar;23(3):409-414. doi: 10.1007/s10157-018-1646-3. Epub 2018 Sep 25.
Although peritoneal dialysis (PD) is becoming more widespread, PD among diabetic patients carries some concerns, such as worsened glycemic control due to constant exposure to glucose and operational errors due to diabetic complications. However, several technical advances could overcome these disadvantages. We, therefore, aimed to compare technical and patient survival between diabetic and non-diabetic PD patients.
We conducted a historical cohort study of 103 patients (mean age, 57 ± 16 years; 75 males, 32 diabetic patients) who started PD between January 2011 and January 2016. Kaplan-Meier survival analysis was used to compare technical and patient survivals between diabetic and non-diabetic patients. Multivariate Cox regression analysis was used to estimate the effects of the presence of diabetes on these outcomes.
Technical and patient survivals did not differ significantly between groups (P = 0.62, P = 0.34, respectively). In addition, presence of diabetes affected neither technical nor patient survival in multivariate analysis (hazard ratio [HR], 1.31; 95% confidence interval [CI], 0.58-2.82 and HR 0.80; 95% CI 0.22-2.68, respectively).
Technical and patient survivals of diabetic PD patients were not inferior to those of non-diabetic PD patients. These results suggest that no hesitation is warranted in initiating PD for diabetic patients with end-stage renal disease.
尽管腹膜透析（PD）越来越普遍，但糖尿病患者的腹膜透析存在一些问题，例如因持续接触葡萄糖导致血糖控制恶化，以及因糖尿病并发症导致操作失误。然而，一些技术进步可以克服这些缺点。因此，我们旨在比较糖尿病和非糖尿病腹膜透析患者的技术生存率和患者生存率。
我们对2011年1月至2016年1月开始进行腹膜透析的103例患者（平均年龄57±16岁；男性75例，糖尿病患者32例）进行了一项历史性队列研究。采用Kaplan-Meier生存分析比较糖尿病和非糖尿病患者的技术生存率和患者生存率。多变量Cox回归分析用于评估糖尿病对这些结果的影响。
两组之间的技术生存率和患者生存率无显著差异（分别为P = 0.62，P = 0.34）。此外，在多变量分析中，糖尿病的存在对技术生存率和患者生存率均无影响（风险比[HR]分别为1.31；95%置信区间[CI]为0.58 - 2.82和HR 0.80；95% CI为0.22 - 2.68）。
糖尿病腹膜透析患者的技术生存率和患者生存率并不低于非糖尿病腹膜透析患者。这些结果表明，对于终末期肾病的糖尿病患者开始进行腹膜透析无需犹豫。
