July 23, 2019Scientific ReportsOpen Access

Risk Factors Before Dialysis Predominate as Mortality Predictors in Diabetic Maintenance Dialysis patients

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Why the study?

Whether clinical and biochemical risk factors during the pre-dialysis period affect long-term post-dialysis mortality in diabetic patients was unknown.

Structured PICO

Population

652 diabetic chronic kidney disease (CKD) patients who initiated maintenance dialysis (MD), mean age 67.6, 57.1% male, single center in south Israel. Key inclusion: prior diagnosis of diabetes, dialysis treatment period and total follow-up time ≥90 days. Key exclusion: other known primary renal disease, developed diabetes only after dialysis, started MD prior to age 40.

Outcome

All-cause mortality (time elapsed from MD initiation to mortality, transplantation, or end of study)hard clinical

Clinical and biochemical risk factors present before dialysis, such as BMI, pulse pressure, and cardiovascular comorbidity, are strong independent predictors of long-term mortality in diabetic patients on maintenance dialysis.

Limitations

Retrospective study design cannot establish causality
Relatively small number of patients from a single center
Frequency difference of tests between patients
Clinical and laboratory parameters derived at only two time points
Exclusion of patients surviving less than 90 days may lead to immortal time bias
Treatment time and access type could not be compared

Discussion

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Implication

BD parameters predict long-term AD mortality in diabetic MD patients; leaves open whether pre-dialysis interventions improve outcomes.

Cite This Study

Tsur et al. (2019) studied this question.

synapsesocial.com/papers/6a70c53926770c2b8de0bb71 https://doi.org/10.1038/s41598-019-46919-w

Topics

Women and heart disease

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Risk Factors Before Dialysis Predominate as Mortality Predictors in Diabetic Maintenance Dialysis patients

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Risk Factors Before Dialysis Predominate as Mortality Predictors in Diabetic Maintenance Dialysis patients

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider