Different mortality predictor pattern in hemodialysis and peritoneal dialysis diabetic patients in 4-year prospective observation
Journal Title: Advances in Hygiene and Experimental Medicine - Year 2013, Vol 67, Issue 0
Abstract
Introduction: The aim was to identify factors carrying an ominous prognosis in a cohort of diabetic patients (pts) on a hemodialysis (HD) and peritoneal dialysis (PD) program.Materials and methods: We analyzed survival rates of 61 diabetic dialysis pts (35 HD/26 PD). The participants were matched in baseline characteristics, standard indicators of dialysis care and laboratory parameters. The studied group was prospectively observed up to 4 years.Results: 21 pts (34.4%) survived the whole observation period. The annual mortality rate was 23.2%, with no difference between HD and PD. Irrespective of dialysis modality, the only factor associated with mortality in the Cox proportional hazard model was serum albumin lowering. Referring to dialysis modality, the HD survivors were characterized by lower IL-6 level, higher albumin concentration, and increased serum cholesterol values with higher cholesterol left in multivariate analysis; under PD therapy the only factor significantly associated with mortality was older age. In contrast to HD treatment, elevated cholesterol was a universal finding in PD patients, significantly above levels in HD, with a slight tendency to lower values in PD survivors.Conclusions: 1. A difference in mortality predictor pattern appeared in diabetic patients treated by PD and HD.2. In the PD group more advanced age had a decisive negative impact on survival whereas in the HD group the outlook was dependent on factors related to nutrition and inflammation. 3. Elevated cholesterol level was associated with survival benefit in HD patients, being a common abnormality in the PD group, without positive prognostic significance.
Authors and Affiliations
Katarzyna Madziarska, Waclaw Weyde, Jozef Penar, Ewa Zukowska-Szczechowska, Magdalena Krajewska, Tomasz Golebiowski, Renata Klak, Slawomir Zmonarski, Cyprian Kozyra, Marian Klinger
Keywords
Related Articles
- EP ID EP67189
- DOI -
- Views 144
- Downloads 0
Molekularne aspekty działania 17β-estradiolu i progesteronu w komórkowych szlakach sygnałowych
17β-estradiol i progesteron, steroidy płciowe omawiane zazwyczaj w związku z modulacją funkcji reprodukcyjnych, regulują wiele wewnątrzkomórkowych procesów w komórkach docelowych, wyposażonych w odpowiednie receptory. Os...
Substancje pochodzenia roślinnego przeciwdziałające kardiotoksyczności towarzyszącej chemioterapii nowotworów
Prawie wszystkie leki przeciwnowotworowe stosowane klinicznie wykazują właściwości toksyczne w stosunku do mięśnia sercowego. Kardiotoksyczność występująca podczas chemioterapii przeciwnowotworowej może być czynnikiem li...
Astrocytes in ischemic stroke – a potential target for neuroprotective strategies
Ischemic stroke is one of the leading causes of adult death and disability worldwide. Present applied therapeutic strategies do not give satisfactory results. It is often emphasized that pharmacological actions aimed at...
Metabolic and nutritional aspects of cancer
Cancer, being in fact a generalized disease involving the whole organism, is most frequently associated with metabolic deregulation, a latent inflammatory state and anorexia of various degrees. The pathogenesis of this d...
The role of the apoptosome in the activation of procaspase-9
Apoptosis, also called programmed cell death, is a physiological process that causes a numberof morphological and biochemical changes, occurring in the cell and leading to its death.Along with the processes of proliferat...