title: The impact of diabetes mellitus on peritoneal dialysis: the Turkey Multicenter Clinic Study.
abstract: OBJECTIVE
  It is well established that diabetic peritoneal dialysis (PD) patients have a higher mortality rate than the other PD population. This study was designed to determine the overall predictors of survival and compared mortality and morbidity between diabetic and non-diabetic Turkish PD patients.
  
  
  METHODS
  We conducted a multicenter retrospective study with 915 PD patients [217 had diabetes mellitus (DM)]. Serum albumin, PTH, HbA1c, co-morbid diseases, dialysis adequacy (Kt/V), and peritoneal transport characteristics as well as peritonitis episodes and ultrafiltration failure during the follow-up period were recorded.
  
  
  RESULTS
  DM patients were older and had more co-morbidities than non-DM patients. Peritonitis rates were higher in DM patients (one episode per 35.9 patient months) compared to non-DM patients (one episode per 41.5 patient months) (p < 0.001). On Kaplan-Meier analysis, patient survival was significantly lower in DM patients with the 2-, 3- and 5-year patient survival rates of 90.8%, 87.8% and 78.2% in non-diabetics and 80.9%, 70.4% and 61.2% in diabetics, respectively. On Cox regression analysis, DM (HR 1.5, p = 0.022), age (HR 1.03, p < 0.001), baseline serum albumin (HR 0.39, p < 0.001), heart failure (HR 0.038, p = 0.038), peripheral artery disease (HR 1.83, p = 0.025) and amputation (HR 4.1, p = 0.009) at baseline were significant predictors of overall mortality.
  
  
  CONCLUSIONS
  Patient survival is lower in diabetic compared to non-diabetic patients on PD. Peritonitis rates were also higher in diabetic PD patients. DM, older age, albumin level and cardiovascular co-morbidities are predictors of mortality.
authors.affiliation: Turkish Multicenter Peritoneal Dialysis Study Group , Istanbul , Turkey and.
authors.forename: Cetin
authors.initials: C
authors.lastname: Ozener
authors.forename: Hakki
authors.initials: H
authors.lastname: Arikan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Karayaylali
authors.forename: Cengiz
authors.initials: C
authors.lastname: Utas
authors.forename: Semra
authors.initials: S
authors.lastname: Bozfakioglu
authors.forename: Tekin
authors.initials: T
authors.lastname: Akpolat
authors.forename: Rezzan
authors.initials: R
authors.lastname: Ataman
authors.forename: Fevzi
authors.initials: F
authors.lastname: Ersoy
authors.forename: Taner
authors.initials: T
authors.lastname: Camsari
authors.forename: Mahmut
authors.initials: M
authors.lastname: Yavuz
authors.forename: Fehmi
authors.initials: F
authors.lastname: Akcicek
authors.forename: M Emin
authors.initials: ME
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D003925:Diabetic Angiopathies / Q000150:complications; D058065:Diabetic Cardiomyopathies / Q000150:complications; D003928:Diabetic Nephropathies / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006333:Heart Failure / Q000150:complications; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D058729:Peripheral Arterial Disease / Q000150:complications; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000401:mortality*; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D015996:Survival Rate; D014421:Turkey / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin; D010281:Parathyroid Hormone; D012709:Serum Albumin