Determinant Effects of Average Fasting Plasma Glucose on Mortality in Diabetic End-Stage Renal Disease Patients on Maintenance Hemodialysis
Diabetic kidney disease is an increasingly frequent cause of end-stage renal disease. However, mixed results were shown between glycated hemoglobin and mortality. Methods: We used the average fasting plasma glucose (FPG) levels to predict mortality rates in long-term hemodialysis patients. We enroll...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-01-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024916300729 |
| _version_ | 1818410555687305216 |
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| author | Yi-Chun Lin Yen-Chung Lin Hsi-Hsien Chen Tzen-Wen Chen Chih-Cheng Hsu Mai-Szu Wu |
| author_facet | Yi-Chun Lin Yen-Chung Lin Hsi-Hsien Chen Tzen-Wen Chen Chih-Cheng Hsu Mai-Szu Wu |
| author_sort | Yi-Chun Lin |
| collection | DOAJ |
| description | Diabetic kidney disease is an increasingly frequent cause of end-stage renal disease. However, mixed results were shown between glycated hemoglobin and mortality.
Methods: We used the average fasting plasma glucose (FPG) levels to predict mortality rates in long-term hemodialysis patients. We enrolled 46,332 hemodialysis patients with diabetes mellitus, who were registered in the Taiwan Renal Registry Data System between January 2005 and December 2012. The patients were stratified based on the quartiles of average FPG levels measured for the first (1-year FPG) and third years (3-year FPG) of hemodialysis. Survival analysis was conducted via multivariable Cox regression.
Results: After the first year of hemodialysis, the mean FPG levels were 103.5 ± 14.5, 144.7 ± 11.5, 189.6 ± 15.2, and 280.8 ± 1.2 mg/dl for the first, second, third, and fourth quartile, respectively. The Kaplan-Meier curve showed an incremental reduction in the survival as FPG levels increased (P < 0.0001). In the Cox regression model, the adjusted hazard ratios were 1.15 (95% CI: 1.10–1.20), 1.30 (95% CI: 1.25–1.36), and 1.45 (95% CI: 1.39–1.51) for the pairwise comparisons between the first quartile and the second, third, and fourth quartile, respectively. Similar trends were observed by 3-year FPG. Patients whose FPG levels increased had a 22% increased risk (95% CI: 1.16–1.29) for all-cause mortality compared with patients whose FPG levels decreased.
Discussion: Our results suggest that the average FPG levels are useful predictors of all-cause mortality in dialysis patients. In addition, an increasing trend in average FPG levels indicates poor survival. |
| first_indexed | 2024-12-14T10:17:23Z |
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| institution | Directory Open Access Journal |
| issn | 2468-0249 |
| language | English |
| last_indexed | 2024-12-14T10:17:23Z |
| publishDate | 2017-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj.art-741bbb5685ad409890e4b57691dd8fd72022-12-21T23:06:45ZengElsevierKidney International Reports2468-02492017-01-0121182610.1016/j.ekir.2016.08.020Determinant Effects of Average Fasting Plasma Glucose on Mortality in Diabetic End-Stage Renal Disease Patients on Maintenance HemodialysisYi-Chun Lin0Yen-Chung Lin1Hsi-Hsien Chen2Tzen-Wen Chen3Chih-Cheng Hsu4Mai-Szu Wu5Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanGraduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, TaiwanDivision of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, TaiwanDivision of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, TaiwanInstitute of Population Health Science, National Health Research Institutes, Zhunan, TaiwanDivision of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, TaiwanDiabetic kidney disease is an increasingly frequent cause of end-stage renal disease. However, mixed results were shown between glycated hemoglobin and mortality. Methods: We used the average fasting plasma glucose (FPG) levels to predict mortality rates in long-term hemodialysis patients. We enrolled 46,332 hemodialysis patients with diabetes mellitus, who were registered in the Taiwan Renal Registry Data System between January 2005 and December 2012. The patients were stratified based on the quartiles of average FPG levels measured for the first (1-year FPG) and third years (3-year FPG) of hemodialysis. Survival analysis was conducted via multivariable Cox regression. Results: After the first year of hemodialysis, the mean FPG levels were 103.5 ± 14.5, 144.7 ± 11.5, 189.6 ± 15.2, and 280.8 ± 1.2 mg/dl for the first, second, third, and fourth quartile, respectively. The Kaplan-Meier curve showed an incremental reduction in the survival as FPG levels increased (P < 0.0001). In the Cox regression model, the adjusted hazard ratios were 1.15 (95% CI: 1.10–1.20), 1.30 (95% CI: 1.25–1.36), and 1.45 (95% CI: 1.39–1.51) for the pairwise comparisons between the first quartile and the second, third, and fourth quartile, respectively. Similar trends were observed by 3-year FPG. Patients whose FPG levels increased had a 22% increased risk (95% CI: 1.16–1.29) for all-cause mortality compared with patients whose FPG levels decreased. Discussion: Our results suggest that the average FPG levels are useful predictors of all-cause mortality in dialysis patients. In addition, an increasing trend in average FPG levels indicates poor survival.http://www.sciencedirect.com/science/article/pii/S2468024916300729end-stage renal diseasefasting blood glucosehemodialysismortalityrenal replacement therapy |
| spellingShingle | Yi-Chun Lin Yen-Chung Lin Hsi-Hsien Chen Tzen-Wen Chen Chih-Cheng Hsu Mai-Szu Wu Determinant Effects of Average Fasting Plasma Glucose on Mortality in Diabetic End-Stage Renal Disease Patients on Maintenance Hemodialysis Kidney International Reports end-stage renal disease fasting blood glucose hemodialysis mortality renal replacement therapy |
| title | Determinant Effects of Average Fasting Plasma Glucose on Mortality in Diabetic End-Stage Renal Disease Patients on Maintenance Hemodialysis |
| title_full | Determinant Effects of Average Fasting Plasma Glucose on Mortality in Diabetic End-Stage Renal Disease Patients on Maintenance Hemodialysis |
| title_fullStr | Determinant Effects of Average Fasting Plasma Glucose on Mortality in Diabetic End-Stage Renal Disease Patients on Maintenance Hemodialysis |
| title_full_unstemmed | Determinant Effects of Average Fasting Plasma Glucose on Mortality in Diabetic End-Stage Renal Disease Patients on Maintenance Hemodialysis |
| title_short | Determinant Effects of Average Fasting Plasma Glucose on Mortality in Diabetic End-Stage Renal Disease Patients on Maintenance Hemodialysis |
| title_sort | determinant effects of average fasting plasma glucose on mortality in diabetic end stage renal disease patients on maintenance hemodialysis |
| topic | end-stage renal disease fasting blood glucose hemodialysis mortality renal replacement therapy |
| url | http://www.sciencedirect.com/science/article/pii/S2468024916300729 |
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