1397-P: Mortality Patterns in Patients with and without Diabetes Undergoing Dialysis

Introduction and Objective: Dialysis patients with diabetes have higher all-cause mortality than those without diabetes. We examined how mortality risk varies across short- and long-term dialysis duration in patients with and without diabetes. Methods: We conducted a retrospective cohort study of patients with and without diabetes undergoing dialysis at an academic dialysis program from 1/2010 to 12/2023. Cox proportional hazards models were used to assess the association between dialysis duration and all-cause mortality. Results: Among 1496 patients without diabetes and 1479 with diabetes, mortality was 26.1% and 37.1%, respectively, after a median dialysis duration of 729 and 962 days. In patients without diabetes, hazard ratios for mortality showed a nonlinear pattern across dialysis duration, with higher risk in the early period, followed by relative attenuation over time. Patients with diabetes had substantially elevated mortality during the initial years, which was maintained across dialysis duration compared with patients without diabetes (Fig). Conclusion: Diabetes is a major modifier of both short- and long-term survival on dialysis. We report a time-dependent (“J-shaped”) all-cause mortality pattern in patients without diabetes. In contrast, patients with diabetes have a higher linear mortality risk during the initial years that persists across dialysis duration compared to patients without diabetes. Disclosure P. Kim: None. J. Navarrete: None. V.S. Diaz-Sarmiento: None. S.L. Kantipudi: None. K. Petty Jr: None. G. Umpierrez: Research Support; Current; Abbott, Dexcom, Inc., Bayer AG. Advisory Panel; Ended; Sanofi-Aventis U.S., Dexcom, Inc. Other - Education grant; Current; Lilly Diabetes, Abbott Diabetes. Advisory Panel; Current; Glycare, Glucotrack. Research Support; Current; Corcept Therapeutics.