Nephrology Dialysis Transplantation, Vol 12, Issue 10 2105-2110, Copyright © 1997 by Oxford University Press
M Wu, C Yu, C Yang, C Wu, J Haung, J Hong, C Chiang, C Huang and M Leu
Background: In type II diabetic patients, a better
glycaemic control has been reported to slow down the progression of
nephropathy. The effect of pre-dialysis glycaemic control on the long term
prognosis in type II diabetics on haemodialysis is still uncertain. The
purpose of this study is to evaluate the effect of glycaemic control before
starting maintenance haemodialysis on the clinical outcome in type II
diabetic haemodialysis patients. Methods: One hundred
and thirty-seven type II diabetics receiving regular haemodialysis in a
single university hospital were enrolled. The patients were classified as
either good or poor glycaemic control group according to their glycaemic
control within 6 months before starting haemodialysis. Serum albumin,
haematocrit, cholesterol, triglyceride, residual renal function, diabetic
complications, and patient survival were analysed.
Results: There was no significant difference in age,
gender, predialysis albumin level, cholesterol level, triglyceride level,
and residual renal function between the two groups. The 1-year (94.5% vs
80.0%), 2-year (82.9% vs 58.1%), and 5-year (75.8% vs 21.8%) cumulative
survival rates were lower in the poor glycaemic control group than in the
good glycaemic control group (P <0.001). The poor glycaemic control
group also had more cardiovascular morbidity during the period of dialysis
(P <0.001). The increase in cardiovascular complications also
accounted for the increased mortality during the course of haemodialysis.
Conclusions: We conclude that poor glycaemic control
before starting dialysis is a strong predictor of cardiovascular morbidity
and survival for type II diabetics on haemodialysis. These results imply
that better glycaemic control before dialysis might be important in
improving the long-term prognosis in type II diabetics on haemodialysis.
Keywords: haemodialysis; pre-dialysis glycaemic
control; type II diabetes
ORIGINAL ARTICLES
Poor pre-dialysis glycaemic control is a predictor of mortality in type II diabetic patients on maintenance haemodialysis
Division of Nephrology, Chang-Gung Memorial Hospital, 199 Tun-Hwa North Road, Taipei, Taiwan; Corresponding author
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