Increased Peritoneal Protein Loss and Diabetes: Is There a Link?
Increased peritoneal protein loss has been associated with the fast transport of small molecules, diabetes mellitus (DM), and a reduced survival in patients on peritoneal dialysis (PD), although some studies did not confirm the association with survival. In this single-center retrospective study, we...
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| Format: | Article |
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MDPI AG
2023-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/7/2670 |
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| author | Ana Bontić Selena Gajić Danka Bjelić Jelena Pavlović Verica Stanković-Popović Milan Radović Aleksandra Kezić |
| author_facet | Ana Bontić Selena Gajić Danka Bjelić Jelena Pavlović Verica Stanković-Popović Milan Radović Aleksandra Kezić |
| author_sort | Ana Bontić |
| collection | DOAJ |
| description | Increased peritoneal protein loss has been associated with the fast transport of small molecules, diabetes mellitus (DM), and a reduced survival in patients on peritoneal dialysis (PD), although some studies did not confirm the association with survival. In this single-center retrospective study, we investigated the relationship of baseline peritoneal albumin and protein loss with transport status, comorbidities including DM, and survival in 106 incident PD patients during the period of July 2005–June 2014. Five-year survival rate was determined using Cox-regression analysis. There were not significant differences in D/Pcr or peritoneal protein and albumin loss between diabetics and non-diabetics. In the group of 66 non-diabetics, high and high-average transporters for creatinine had higher values for both peritoneal protein (11.85 ± 6.77 vs. 7.85 ± 4.36 g/day; <i>p</i> = 0.002) and albumin (5.03 ± 2.32 vs. 3.72 ± 1.54 g/day; <i>p</i> = 0.016) loss as compared to slow transporters. However, in the group of 40 diabetics, this association was not observed. Upon multivariable regression analysis, the independent association of D/PCr with peritoneal albumin (β = 0.313; <i>p</i> = 0.008) and protein (β = 0.441; <i>p</i> = 0.001) loss was found only in non-diabetics in whom ultrafiltration also appeared as a significant predictor of peritoneal protein loss (<i>β</i> = 0.330; <i>p</i> = 0.000). A high comorbidity grade, older age, and low serum albumin were associated with mortality, but both peritoneal protein and albumin loss as well as D/Pcr were not determinants of survival. Baseline peritoneal protein and albumin loss was not associated with DM and did not predict survival. The clinical significance of the absence of association between fast peritoneal transport status and peritoneal protein flux in diabetics should be evaluated in a prospective study comprising a greater number of diabetics with evaluation of overhydration as a main inducing variable of protein leak. |
| first_indexed | 2024-03-11T05:33:06Z |
| format | Article |
| id | doaj.art-b1398890392c44c29f9a45685ba9f3bf |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T05:33:06Z |
| publishDate | 2023-04-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b1398890392c44c29f9a45685ba9f3bf2023-11-17T17:00:19ZengMDPI AGJournal of Clinical Medicine2077-03832023-04-01127267010.3390/jcm12072670Increased Peritoneal Protein Loss and Diabetes: Is There a Link?Ana Bontić0Selena Gajić1Danka Bjelić2Jelena Pavlović3Verica Stanković-Popović4Milan Radović5Aleksandra Kezić6Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, SerbiaClinic for Nephrology, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, SerbiaClinic for Nephrology, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, SerbiaIncreased peritoneal protein loss has been associated with the fast transport of small molecules, diabetes mellitus (DM), and a reduced survival in patients on peritoneal dialysis (PD), although some studies did not confirm the association with survival. In this single-center retrospective study, we investigated the relationship of baseline peritoneal albumin and protein loss with transport status, comorbidities including DM, and survival in 106 incident PD patients during the period of July 2005–June 2014. Five-year survival rate was determined using Cox-regression analysis. There were not significant differences in D/Pcr or peritoneal protein and albumin loss between diabetics and non-diabetics. In the group of 66 non-diabetics, high and high-average transporters for creatinine had higher values for both peritoneal protein (11.85 ± 6.77 vs. 7.85 ± 4.36 g/day; <i>p</i> = 0.002) and albumin (5.03 ± 2.32 vs. 3.72 ± 1.54 g/day; <i>p</i> = 0.016) loss as compared to slow transporters. However, in the group of 40 diabetics, this association was not observed. Upon multivariable regression analysis, the independent association of D/PCr with peritoneal albumin (β = 0.313; <i>p</i> = 0.008) and protein (β = 0.441; <i>p</i> = 0.001) loss was found only in non-diabetics in whom ultrafiltration also appeared as a significant predictor of peritoneal protein loss (<i>β</i> = 0.330; <i>p</i> = 0.000). A high comorbidity grade, older age, and low serum albumin were associated with mortality, but both peritoneal protein and albumin loss as well as D/Pcr were not determinants of survival. Baseline peritoneal protein and albumin loss was not associated with DM and did not predict survival. The clinical significance of the absence of association between fast peritoneal transport status and peritoneal protein flux in diabetics should be evaluated in a prospective study comprising a greater number of diabetics with evaluation of overhydration as a main inducing variable of protein leak.https://www.mdpi.com/2077-0383/12/7/2670peritoneal dialysisperitoneal protein lossdiabetes mellitusperitoneal membrane transport statuscomorbiditymortality |
| spellingShingle | Ana Bontić Selena Gajić Danka Bjelić Jelena Pavlović Verica Stanković-Popović Milan Radović Aleksandra Kezić Increased Peritoneal Protein Loss and Diabetes: Is There a Link? Journal of Clinical Medicine peritoneal dialysis peritoneal protein loss diabetes mellitus peritoneal membrane transport status comorbidity mortality |
| title | Increased Peritoneal Protein Loss and Diabetes: Is There a Link? |
| title_full | Increased Peritoneal Protein Loss and Diabetes: Is There a Link? |
| title_fullStr | Increased Peritoneal Protein Loss and Diabetes: Is There a Link? |
| title_full_unstemmed | Increased Peritoneal Protein Loss and Diabetes: Is There a Link? |
| title_short | Increased Peritoneal Protein Loss and Diabetes: Is There a Link? |
| title_sort | increased peritoneal protein loss and diabetes is there a link |
| topic | peritoneal dialysis peritoneal protein loss diabetes mellitus peritoneal membrane transport status comorbidity mortality |
| url | https://www.mdpi.com/2077-0383/12/7/2670 |
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