Predialysis glycemic control is an independent predictor of clinical outcome in type II diabetics on continuous ambulatory peritoneal dialysis. 1997

C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
Division of Nephrology, Chang-Gung Memorial Hospital, Taipei, Taiwan.

OBJECTIVE To evaluate the correlation between predialysis glycemic control and clinical outcomes for type II diabetic patients on continuous ambulatory peritoneal dialysis (CAPD). METHODS Sixty type II diabetic patients on CAPD were classified into 2 groups according to the status of glycemic control. In group G (good glycemic control), more than 50% of blood glucose determinations were within 3.3-11 mmol/L and the glycosylated hemoglobin (HbA1C) level was within 5-10% at all times. In group P (poor glycemic control), fewer than 50% of blood glucose determinations were within 3.3-11 mmol/L or HbA1C level was above 10% at least once during the follow-up duration. In addition to glycemic control status, predialysis serum albumin, cholesterol levels, residual renal function, peritoneal membrane function, and the modes of glycemic control were also recorded. METHODS Dialysis Unit, Department of Nephrology of a single university hospital. METHODS From February 1988 to October 1995, 60 type II diabetic patients receiving CAPD for at least 3 months were enrolled. METHODS Morbidities before and during the dialysis period, patient survival, and causes of mortality. RESULTS The patients with good glycemic control had significantly better survival than patients with poor glycemic control (p < 0.01). There was no significant difference in predialysis morbidity between the two groups. No significant differences were observed in patient survival between the patients with serum albumin greater than 30 g/L and those with less than 30 g/L (p = 0.77), with cholesterol levels greater or less than 5.18 mmol/L (p = 0.73), and with different peritoneal membrane solute transport characteristics evaluated by peritoneal equilibration test (p = 0.12). Furthermore, there was no significant difference in survival whether the patients controlled blood sugar by diet or with insulin (p = 0.33). Cardiovascular disease and infection were the major causes of death in both groups. Although good glycemic control predicts better survival, it does not change the pattern of mortality in diabetics maintained on CAPD. CONCLUSIONS Glycemic control before starting dialysis is a predictor of survival for type II diabetics on CAPD. Patients with poor glycemic control predialysis are associated with increased morbidity and shortened survival.

UI MeSH Term Description Entries
D006973 Hypertension Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more. Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D007003 Hypoglycemia A syndrome of abnormally low BLOOD GLUCOSE level. Clinical hypoglycemia has diverse etiologies. Severe hypoglycemia eventually lead to glucose deprivation of the CENTRAL NERVOUS SYSTEM resulting in HUNGER; SWEATING; PARESTHESIA; impaired mental function; SEIZURES; COMA; and even DEATH. Fasting Hypoglycemia,Postabsorptive Hypoglycemia,Postprandial Hypoglycemia,Reactive Hypoglycemia,Hypoglycemia, Fasting,Hypoglycemia, Postabsorptive,Hypoglycemia, Postprandial,Hypoglycemia, Reactive
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009203 Myocardial Infarction NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION). Cardiovascular Stroke,Heart Attack,Myocardial Infarct,Cardiovascular Strokes,Heart Attacks,Infarct, Myocardial,Infarction, Myocardial,Infarctions, Myocardial,Infarcts, Myocardial,Myocardial Infarctions,Myocardial Infarcts,Stroke, Cardiovascular,Strokes, Cardiovascular
D010531 Peritoneal Dialysis, Continuous Ambulatory Portable peritoneal dialysis using the continuous (24 hours a day, 7 days a week) presence of peritoneal dialysis solution in the peritoneal cavity except for periods of drainage and instillation of fresh solution. CAPD,Continuous Ambulatory Peritoneal Dialysis
D011506 Proteins Linear POLYPEPTIDES that are synthesized on RIBOSOMES and may be further modified, crosslinked, cleaved, or assembled into complex proteins with several subunits. The specific sequence of AMINO ACIDS determines the shape the polypeptide will take, during PROTEIN FOLDING, and the function of the protein. Gene Products, Protein,Gene Proteins,Protein,Protein Gene Products,Proteins, Gene
D002318 Cardiovascular Diseases Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM. Adverse Cardiac Event,Cardiac Events,Major Adverse Cardiac Events,Adverse Cardiac Events,Cardiac Event,Cardiac Event, Adverse,Cardiac Events, Adverse,Cardiovascular Disease,Disease, Cardiovascular,Event, Cardiac
D002415 Cats The domestic cat, Felis catus, of the carnivore family FELIDAE, comprising over 30 different breeds. The domestic cat is descended primarily from the wild cat of Africa and extreme southwestern Asia. Though probably present in towns in Palestine as long ago as 7000 years, actual domestication occurred in Egypt about 4000 years ago. (From Walker's Mammals of the World, 6th ed, p801) Felis catus,Felis domesticus,Domestic Cats,Felis domestica,Felis sylvestris catus,Cat,Cat, Domestic,Cats, Domestic,Domestic Cat
D002561 Cerebrovascular Disorders A spectrum of pathological conditions of impaired blood flow in the brain. They can involve vessels (ARTERIES or VEINS) in the CEREBRUM, the CEREBELLUM, and the BRAIN STEM. Major categories include INTRACRANIAL ARTERIOVENOUS MALFORMATIONS; BRAIN ISCHEMIA; CEREBRAL HEMORRHAGE; and others. Brain Vascular Disorders,Intracranial Vascular Disorders,Vascular Diseases, Intracranial,Cerebrovascular Diseases,Cerebrovascular Insufficiency,Cerebrovascular Occlusion,Brain Vascular Disorder,Cerebrovascular Disease,Cerebrovascular Disorder,Cerebrovascular Insufficiencies,Cerebrovascular Occlusions,Disease, Cerebrovascular,Diseases, Cerebrovascular,Insufficiencies, Cerebrovascular,Insufficiency, Cerebrovascular,Intracranial Vascular Disease,Intracranial Vascular Diseases,Intracranial Vascular Disorder,Occlusion, Cerebrovascular,Occlusions, Cerebrovascular,Vascular Disease, Intracranial,Vascular Disorder, Brain,Vascular Disorder, Intracranial,Vascular Disorders, Brain,Vascular Disorders, Intracranial

Related Publications

C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
July 1993, Annals of the Academy of Medicine, Singapore,
C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
July 1992, The International journal of artificial organs,
C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
January 1988, Nephrologie,
C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
January 1993, Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis,
C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
September 2004, Renal failure,
C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
July 1994, Clinical nephrology,
C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
January 1983, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association,
C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
March 1981, Medizinische Klinik,
C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
January 1991, Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis,
C C Yu, and M S Wu, and C H Wu, and C W Yang, and J Y Huang, and J J Hong, and C Y Fan Chiang, and M L Leu, and C C Huang
January 1992, Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis,
Copied contents to your clipboard!