Triglyceride-glucose index and the outcome of peritoneal dialysis patients: analysis of two cohorts

Background Cardiovascular disease is the leading cause of death in patients with chronic kidney disease and those on peritoneal dialysis (PD), with insulin resistance contributing significantly to adverse outcomes. This study evaluates the triglyceride-glucose (TyG) index as a prognostic marker for metabolic dysfunction in PD patients. Methods We studied two patient cohorts: 278 new PD patients and 178 prevalent ones. TyG index values were calculated by a validated formula. The patients were followed for 28.0 ± 12.6 (incident PD cohort) and 43.9 ± 37.6 months (prevalent PD cohort) for survival and hospitalization. Results The mean TyG index was 8.70 ± 0.61 and 9.01 ± 0.72 in the new and prevalent PD cohort, respectively ( p < 0.0001). In the incident PD cohort, the 2-year patient survival rates for quartiles I to IV of TyG were 84.0%, 85.9%, 79.8%, and 73.8%, respectively ( p = 0.045). However, after adjustment for confounders, TyG was not an independent predictor of patient survival (adjusted hazard ratio 0.958, 95% confidence interval 0.732 to 1.123, p = 0.753). In the prevalent PD cohort, the 2-year patient survival rates for quartiles I to IV of TyG were 68.9%, 75.0%, 84.4%, and 75.0%, respectively ( p = 0.364). In both cohorts, TyG index showed no significant association with technique survival rate, hospitalization rates, duration of hospitalization, or peritonitis rates. Conclusions The TyG index was higher in prevalent PD patients but was not an independent predictor of patient or technique survival, hospitalization, or peritonitis rate after multivariate adjustment. Although correlated with metabolic parameters, the TyG index did not serve as a prognostic marker in PD patients.