title: Poor pre-dialysis glycaemic control is a predictor of mortality in type II diabetic patients on maintenance haemodialysis.
abstract: BACKGROUND
  In type II diabetic patients, a better glycaemic control has been reported to slow down the progression of nephropathy. The effect of pre-dialysis glycaemic control on the long term prognosis in type II diabetics on haemodialysis is still uncertain. The purpose of this study is to evaluate the effect of glycaemic control before starting maintenance haemodialysis on the clinical outcome in type II diabetic haemodialysis patients.
  
  
  METHODS
  One hundred and thirty-seven type II diabetics receiving regular haemodialysis in a single university hospital were enrolled. The patients were classified as either good or poor glycaemic control group according to their glycaemic control within 6 months before starting haemodialysis. Serum albumin, haematocrit, cholesterol, triglyceride, residual renal function, diabetic complications, and patient survival were analysed in both groups.
  
  
  RESULTS
  There was no significant difference in age, gender, predialysis albumin level, cholesterol level, triglyceride level, and residual renal function between the two groups. The 1-year (94.5% vs 80.0%), 3-year (82.9% vs 58.1%), and 5-year (75.8% vs 21.8%) cumulative survival rates were lower in the poor glycaemic control group than in the good glycaemic control group (P < 0.001). The poor glycaemic control group also had more cardiovascular morbidity during the period of dialysis (P < 0.001). The increase in cardiovascular complications also accounted for the increased mortality during the course of haemodialysis.
  
  
  CONCLUSIONS
  We conclude that poor glycaemic control before starting dialysis is a strong predictor of cardiovascular morbidity and survival for type II diabetics on haemodialysis. These results imply that better glycaemic control before dialysis might be important in improving the long-term prognosis in type II diabetics on haemodialysis.
authors.affiliation: Division of Nephrology, Chang-Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: M S
authors.initials: MS
authors.lastname: Wu
authors.forename: C C
authors.initials: CC
authors.lastname: Yu
authors.forename: C W
authors.initials: CW
authors.lastname: Yang
authors.forename: C H
authors.initials: CH
authors.lastname: Wu
authors.forename: J Y
authors.initials: JY
authors.lastname: Haung
authors.forename: J J
authors.initials: JJ
authors.lastname: Hong
authors.forename: C Y
authors.initials: CY
authors.lastname: Fan Chiang
authors.forename: C C
authors.initials: CC
authors.lastname: Huang
authors.forename: M L
authors.initials: ML
authors.lastname: Leu
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D002423:Cause of Death; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D016019:Survival Analysis
chemical_list: D001786:Blood Glucose