title: Different mortality predictor pattern in hemodialysis and peritoneal dialysis diabetic patients in 4-year prospective observation.
abstract: BACKGROUND
  The aim was to identify factors carrying an ominous prognosis in a cohort of diabetic patients (pts) on a hemodialysis (HD) and peritoneal dialysis (PD) program.
  
  
  METHODS
  We analyzed survival rates of 61 diabetic dialysis pts (35 HD/26 PD). The participants were matched in baseline characteristics, standard indicators of dialysis care and laboratory parameters. The studied group was prospectively observed up to 4 years.
  
  
  RESULTS
  21 pts (34.4%) survived the whole observation period. The annual mortality rate was 23.2%, with no difference between HD and PD. Irrespective of dialysis modality, the only factor associated with mortality in the Cox proportional hazard model was serum albumin lowering. Referring to dialysis modality, the HD survivors were characterized by lower IL-6 level, higher albumin concentration, and increased serum cholesterol values with higher cholesterol left in multivariate analysis; under PD therapy the only factor significantly associated with mortality was older age. In contrast to HD treatment, elevated cholesterol was a universal finding in PD patients, significantly above levels in HD, with a slight tendency to lower values in PD survivors.
  
  
  CONCLUSIONS
  1. A difference in mortality predictor pattern appeared in diabetic patients treated by PD and HD. 2. In the PD group more advanced age had a decisive negative impact on survival whereas in the HD group the outlook was dependent on factors related to nutrition and inflammation. 3. Elevated cholesterol level was associated with survival benefit in HD patients, being a common abnormality in the PD group, without positive prognostic significance.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Madziarska
authors.affiliation: Faculty of Dentistry, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Waclaw
authors.initials: W
authors.lastname: Weyde
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Jozef
authors.initials: J
authors.lastname: Penar
authors.affiliation: Internal Medicine, Diabetology and Nephrology, Medical University of Silesia, Zabrze, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Zukowska-Szczechowska
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Krajewska
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Golebiowski
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Renata
authors.initials: R
authors.lastname: Klak
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Slawomir
authors.initials: S
authors.lastname: Zmonarski
authors.affiliation: Department of Statistics, Wroclaw University of Economics, Wroclaw, Poland.
authors.forename: Cyprian
authors.initials: C
authors.lastname: Kozyra
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
mesh_terms: D000367:Age Factors; D000368:Aged; D002784:Cholesterol / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood / Q000401:mortality* / Q000628:therapy*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality*; D012709:Serum Albumin / Q000032:analysis; D015996:Survival Rate
chemical_list: D015850:Interleukin-6; D012709:Serum Albumin; D002784:Cholesterol