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Front. Physiol. | doi: 10.3389/fphys.2019.00150

Impact of glucose exposure on outcomes of a nation-wide peritoneal dialysis cohort – results of the BRAZPD II cohort

 Vitor Radunz1, Roberto Pecoits-Filho1, Ana E. Figueiredo2,  Pasqual Barretti3 and  Thyago P. Moraes1*
  • 1Pontifícia Universidade Católica do Paraná, Brazil
  • 2Pontifícia Universidade Católica do Rio Grande do Sul, Brazil
  • 3São Paulo State University, Brazil

Background: Data investigating the association of glucose exposure with technique failure and patient survival are limited to retrospective cohorts and was never tested outside Asia and considering the presence of competing risks.
Method: Prospective multicenter cohort study of incident peritoneal dialysis patients where the association of cumulative glucose exposure in 6,12 and 24 months with patient survival and technique failure was tested using Cox regression analysis and competing risk analysis.
Results: We analyzed 4367 incident peritoneal dialysis patients with mean age 59.0±15.8 years, 43.9% were diabetics, 46.7% males and 64.4% Caucasians. Glucose exposure was not associated with patient survival independent of the time of exposure and even after adjustments for confounders. In contrast, higher glucose exposure was associated with more technique failure in the Cox and competing risk models. The higher risk for technique failure was found in the subgroup exposed to the higher amount of glucose to a maximum of 86% in the model analyzing cumulative glucose exposure for 1 year.
Conclusion: Glucose exposure was associated with technique failure but not with patient survival.

Keywords: Peritoneal Dialysis, cohort, Glucose, Death -, ultrafiltration failure

Received: 21 Aug 2018; Accepted: 07 Feb 2019.

Edited by:

Janusz Witowski, Poznan University of Medical Sciences, Poland

Reviewed by:

Antonio Longo, Università degli Studi di Catania, Italy
Simon J. Davies, Keele University, United Kingdom
Ramon Paniagua, Mexican Social Security Institute (IMSS), Mexico  

Copyright: © 2019 Radunz, Pecoits-Filho, Figueiredo, Barretti and Moraes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD, PhD. Thyago P. Moraes, Pontifícia Universidade Católica do Paraná, Curitiba, 80215-901, Paraná, Brazil, thyagomoraes@hotmail.com