Poor pre-dialysis glycaemic control is a predictor of mortality in type II diabetic patients on maintenance haemodialysis

Mai Szu Wu, Chun Chen Yu, Chih Wei Yang, Ching Herng Wu, Jeng Yi Haung, Jen Jye Hong, Chun Yi Fan Chiang, Chiu Ching Huang, Mei Ling Leu

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Abstract

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 in both groups. 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%), 3-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.

Original languageEnglish
Pages (from-to)2105-2110
Number of pages6
JournalNephrology Dialysis Transplantation
Volume12
Issue number10
DOIs
Publication statusPublished - Oct 1997
Externally publishedYes

Keywords

  • Haemodialysis
  • Pre-dialysis glycaemic control
  • Type II diabetes

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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    Wu, M. S., Yu, C. C., Yang, C. W., Wu, C. H., Haung, J. Y., Hong, J. J., Chiang, C. Y. F., Huang, C. C., & Leu, M. L. (1997). Poor pre-dialysis glycaemic control is a predictor of mortality in type II diabetic patients on maintenance haemodialysis. Nephrology Dialysis Transplantation, 12(10), 2105-2110. https://doi.org/10.1093/ndt/12.10.2105