Kidney Week

Abstract: FR-PO0320

Longitudinal Trends of Mineral and Bone Disorder Markers According to Diabetes Status and Glycemic Control in Patients on Peritoneal Dialysis: From PDOPPS, Korea

Session Information

• CKD-MBD: Mechanistic Insights and Management
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Bone and Mineral Metabolism

• 502 Bone and Mineral Metabolism: Clinical

Authors

• Seok, Suhyeon, Pusan National University Hospital, Busan, Korea (the Republic of)

Suhyeon Seok, MD

• Jeon, Ji Hyun, Pusan National University Hospital, Busan, Korea (the Republic of)

Ji Hyun Jeon, MD

• Kim, Da Woon, Pusan National University Hospital, Busan, Korea (the Republic of)

Da Woon Kim, MD

• Seong, Eun Young, Pusan National University Hospital, Busan, Korea (the Republic of)

Eun Young Seong, MD, PhD

• Song, Sang Heon, Pusan National University Hospital, Busan, Korea (the Republic of)

Sang Heon Song, MD, PhD

Background

This study evaluates the influence of diabetes mellitus (DM) and glycemic control on longitudinal chronic kidney disease-mineral and bone disorder (CKD-MBD) trajectories and fracture risk in peritoneal dialysis (PD) patients, who are continuously exposed to glucose through dialysate.

Methods

We analyzed 766 PD patients (407 non-DM, 359 DM) from the Korea PDOPPS cohort (2019–2021). Linear Mixed Models (LMM) were utilized to evaluate the longitudinal trajectories of MBD markers according to DM status and glycemic control (stratified by HbA1c 8.0%). Cox proportional hazards models were employed to assess fracture risk.

Results

Baseline parathyroid hormone (PTH) (247.0 vs. 311.0 pg/mL) and albumin (3.54 vs. 3.73 g/dL) were lower in the DM group (p<0.001). LMM confirmed DM patients maintained lower PTH and albumin trajectories throughout follow-up (p<0.001). Within the DM group, poor glycemic control (HbA1c ≥8.0%) was associated with lower baseline phosphate (5.07 vs. 5.26 mg/dL, p=0.005) but showed a steeper longitudinal increase (p-interaction=0.040). Regarding fractures, the DM group exhibited a higher hazard ratio (Adjusted hazard ratio 1.647, 95% CI 0.587–4.621) without statistical significance (p=0.343).

Conclusion

DM and hyperglycemia significantly alter CKD-MBD trajectories in PD. Longitudinal phosphate monitoring is essential to avoid misinterpreting mineral status in poorly controlled patients.

Acknowledgment

Data were sourced from PDOPPS, Korea

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