PMID- 35582665
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220519
IS  - 1948-9358 (Print)
IS  - 1948-9358 (Electronic)
IS  - 1948-9358 (Linking)
VI  - 13
IP  - 4
DP  - 2022 Apr 15
TI  - Risk factors for mortality within 6 mo in patients with diabetes undergoing 
      urgent-start peritoneal dialysis: A multicenter retrospective cohort study.
PG  - 376-386
LID - 10.4239/wjd.v13.i4.376 [doi]
AB  - BACKGROUND: The risk of early mortality of patients who start dialysis urgently 
      is high; however, in patients with diabetes undergoing urgent-start peritoneal 
      dialysis (USPD), the risk of, and risk factors for, early mortality are unknown. 
      AIM: To identify risk factors for mortality during high-risk periods in patients 
      with diabetes undergoing USPD. METHODS: This retrospective cohort study enrolled 
      568 patients with diabetes, aged >/= 18 years, who underwent USPD at one of five 
      Chinese centers between 2013 and 2019. We divided the follow-up period into two 
      survival phases: The first 6 mo of USPD therapy and the months thereafter. We 
      compared demographic and baseline clinical data of living and deceased patients 
      during each period. Kaplan-Meier survival curves were generated for all-cause 
      mortality according to the New York Heart Association (NYHA) classification. A 
      multivariate Cox proportional hazard regression model was used to identify risk 
      factors for mortality within the first 6 mo and after 6 mo of USPD. RESULTS: 
      Forty-one patients died within the first 6 mo, accounting for the highest 
      proportion of mortalities (26.62%) during the entire follow-up period. 
      Cardiovascular disease was the leading cause of mortality within 6 mo (26.83%) 
      and after 6 mo (31.86%). The risk of mortality not only within the first 6 mo but 
      also after the first 6 mo was higher for patients with obvious baseline heart 
      failure symptoms than for those with mild or no heart failure symptoms. 
      Independent risk factors for mortality within the first 6 mo were advanced age 
      [hazard ratio (HR: 1.908; 95%CI: 1.400-2.600; P < 0.001), lower baseline serum 
      creatinine level (HR: 0.727; 95%CI: 0.614-0.860; P < 0.001), higher baseline 
      serum phosphorus level (HR: 3.162; 95%CI: 1.848-5.409; P < 0.001), and baseline 
      NYHA class III-IV (HR: 2.148; 95%CI: 1.063-4.340; P = 0.033). Independent risk 
      factors for mortality after 6 mo were advanced age (HR: 1.246; 95%CI: 
      1.033-1.504; P = 0.022) and baseline NYHA class III-IV (HR: 2.015; 95%CI: 
      1.298-3.130; P = 0.002). CONCLUSION: To reduce the risk of mortality within the 
      first 6 mo of USPD in patients with diabetes, controlling the serum phosphorus 
      level and improving cardiac function are recommended.
CI  - (c)The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights 
      reserved.
FAU - Cheng, Si-Yu
AU  - Cheng SY
AD  - Department of Nephrology, The Second Hospital of Jilin University, Changchun 
      130041, Jilin Province, China.
FAU - Yang, Li-Ming
AU  - Yang LM
AD  - Department of Nephrology, The First Hospital of Jilin University-the Eastern 
      Division, Changchun 130041, Jilin Province, China.
FAU - Sun, Zhan-Shan
AU  - Sun ZS
AD  - Department of Nephrology, Xing'anmeng People's Hospital, Ulan Hot 137400, Inner 
      Mongolia Autonomous Region China.
FAU - Zhang, Xiao-Xuan
AU  - Zhang XX
AD  - Department of Nephrology, Jilin FAW General Hospital, Changchun 130041, Jilin 
      Province, China.
FAU - Zhu, Xue-Yan
AU  - Zhu XY
AD  - Department of Nephrology, Jilin Central Hospital, Jilin 132011, Jilin Province, 
      China.
FAU - Meng, Ling-Fei
AU  - Meng LF
AD  - Department of Nephrology, The Second Hospital of Jilin University, Changchun 
      130041, Jilin Province, China.
FAU - Guo, Shi-Zheng
AU  - Guo SZ
AD  - Department of Nephrology, The Second Hospital of Jilin University, Changchun 
      130041, Jilin Province, China.
FAU - Zhuang, Xiao-Hua
AU  - Zhuang XH
AD  - Department of Nephrology, The Second Hospital of Jilin University, Changchun 
      130041, Jilin Province, China.
FAU - Luo, Ping
AU  - Luo P
AD  - Department of Nephrology, The Second Hospital of Jilin University, Changchun 
      130041, Jilin Province, China.
FAU - Cui, Wen-Peng
AU  - Cui WP
AD  - Department of Nephrology, The Second Hospital of Jilin University, Changchun 
      130041, Jilin Province, China. wenpengcui@163.com.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Diabetes
JT  - World journal of diabetes
JID - 101547524
PMC - PMC9052007
OTO - NOTNLM
OT  - Diabetes mellitus, Mortality within the first 6 mo
OT  - End-stage renal disease
OT  - Peritoneal dialysis
OT  - Risk factor
OT  - Urgent start
COIS- Conflict-of-interest statement: All the authors have no conflict of interest 
      related to the manuscript.
EDAT- 2022/05/19 06:00
MHDA- 2022/05/19 06:01
PMCR- 2022/04/15
CRDT- 2022/05/18 02:13
PHST- 2021/11/09 00:00 [received]
PHST- 2022/01/20 00:00 [revised]
PHST- 2022/03/16 00:00 [accepted]
PHST- 2022/05/18 02:13 [entrez]
PHST- 2022/05/19 06:00 [pubmed]
PHST- 2022/05/19 06:01 [medline]
PHST- 2022/04/15 00:00 [pmc-release]
AID - 10.4239/wjd.v13.i4.376 [doi]
PST - ppublish
SO  - World J Diabetes. 2022 Apr 15;13(4):376-386. doi: 10.4239/wjd.v13.i4.376.