Fasting blood glucose level and risk of all-cause and cause-specific mortality in peritoneal dialysis patients

초록

Background:Glycemic control is crucial in peritoneal dialysis (PD) patientswith diabetes. Although fasting blood glucose (FBG) is the most commonlyused index to measure blood glucose levels, there is currently no evidence sup-porting the association between FBG level and mortality risk in PD patients.Methods:A total of 3548 diabetic PD patients between 2002 and 2018 wereenrolled from the National Health Insurance Service database of Korea. Weinvestigated the association between FBG levels and the risk of all-cause andcause-specific mortality.Results:Patients with FBG levels 80-99 mg/dL exhibited the highest survivalrates, whereas those with FBG levels >= 180 mg/dL had the lowest survival rates.Compared with FBG levels 80-99 mg/dL, the adjusted hazard ratios and 95%confidence interval for all-cause mortality significantly increased as follows:1.02 (0.87-1.21), 1.41 (1.17-1.70), 1.44 (1.18-2.75), and 2.05 (1.73-2.42) forpatients with FBG 100-124 mg/dL, FBG 125-149 mg/dL, FBG 150-179 mg/dL,and FBG >= 180 mg/dL, respectively. The risk for all-cause mortality alsoshowed an increasing pattern in patients with FBG levels <80 mg/L. The riskof cardiovascular death significantly increased as FBG levels exceeded 125 mg/dL. However, the risk of infection-related and malignancy-related deaths didnot show a significant increase with increasing FBG levels.Conclusion:There was an increase in the risk of all-cause mortality as FBGlevels exceeded 125 mg/dL in PD patients with diabetes, and the risk of cardio-vascular death showed a strong correlation with FBG levels compared withother causes of death.

키워드