[Patients on peritoneal dialysis with type 2 diabetes present poorer progress than non-diabetics at the expense of their cardiovascular comorbidity].
OBJECTIVE
To describe the characteristics, practice patterns, targets and outcome of the Type 2 diabetic patients (DM 2) in peritoneal dialysis (PD) and to compare them with non-diabetic ones.


METHODS
Prospective cohort study of every incident PD patient in a regional public health care system (2003-2006). We prospectively collected baseline data, hospital admissions, peritonitis, transplants, CV events and deaths. Every six months PD prescription data and results on efficacy, anaemia, blood pressure (BP) were collected.


RESULTS
DM 2 patients (n = 65) were older and presented a higher rate of previous CV events (60.9% vs. 17.7% p<0001) than non-DM patients (n = 376) and worse BP control at inclusion on PD. There were no differences in dialysis efficacy targets and anaemia management. HOSPITAL ADMISSIONS: DM 2 patients present higher hospitalisation rates 1.1 [0.9-1.4] than NoDM ones 0.6 [0.5-0.7] admissions per year at risk. Survival: DM 2 patients present lower PD-technique survival than No DM ones (870 vs. 1002 days Kaplan-Mayer estimation p = 0.009) and higher annual mortality rate (13.7 vs. 4.1%, p: 0.021) with a crude mortality hazard ratio (HR) of 2.5 [1.1-5.6] after correction by age. However, the best predictive model for mortality by Cox proportional hazards model includes age, existence of previous CV events and forced inclusion on PD and excludes DM 2. The association between DM 2 and CV events ruled out DM 2 from the multivariate risk model.


CONCLUSIONS
Type 2 DM patients had a higher prevalence of previous CV events, and a worse global outcome. Previous CV events may explain part of this risk.
Portolés
J
J
Hospital Universitario Fundación Alcorcón, Madrid. jmportoles@fhalcorcon.es
Corchete
E
E
López-Sánchez
P
P
Coronel
F
F
Ocaña
J
J
Ortiz
A
A
D002318:Cardiovascular Diseases / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate