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Kidney Week

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 modelMultivariate model
variableHR95% CIpHR95% CIp
Age (60<)0.3090.040-2.3660.2580.3330.039-2.8120.336
Gender (male)0.8880.278-2.8400.8421.2150.301-4.9040.784
Time average A1c 8.0≤3.1601.096-9.1130.0333.7411.166-11.9080.026
PD modality (APD vs. CAPD)0.8690.301-2.5060.7950.4960.127-1.9310.312
Exposure to High concentrate glucose0.5570.184-1.6810.5830.5040.108-2.3570.658
Use of Icodextrin1.0120.339-3.0240.9831.1790.348-3.9970.881
Hypertension6.2550.917-47.8850.0770.5170.119-1.6680.377
Cardiovascular disease0.3890.121-1.2520.1130.4300.111-1.6680.222

Funding

  • Veterans Affairs Support