Impact of gender and dialysis modality on early mortality risk in diabetic ESRD patients: data from a large single center cohort

Background Diabetes mellitus (DM)-associated chronic kidney disease (diabetic renal disease) became the predominant etiology of the end-stage renal disease (ESRD) in the western countries and shows the same trend in the developing countries. Early mortality (EM) after the dialysis initiation, define...

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Bibliographic Details
Published in:International urology and nephrology 2014-03, Vol.46 (3), p.607-614
Main Authors: Serafinceanu, C., Neculaescu, C., Cimponeriu, D., Timar, R., Covic, A. C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Case-Control Studies
Diabetic Nephropathies - mortality
Diabetic Nephropathies - therapy
Female
Humans
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - mortality
Kidney Failure, Chronic - therapy
Male
Medicine
Medicine & Public Health
Middle Aged
Nephrology
Nephrology - Original Paper
Renal Dialysis - methods
Retrospective Studies
Risk Factors
Sex Factors
Time Factors
Urology
Young Adult
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Summary:Background Diabetes mellitus (DM)-associated chronic kidney disease (diabetic renal disease) became the predominant etiology of the end-stage renal disease (ESRD) in the western countries and shows the same trend in the developing countries. Early mortality (EM) after the dialysis initiation, defined as death of all causes within the first 3 months after initiation of renal replacement therapy (RRT), is of concern especially for the high-risk renal patients including diabetics. The goal of the present study was to identify demographic and clinical risk factors associated with EM in a retrospective cohort of Romanian DM patients initiated on dialysis. Methods A retrospective case–control study was designed. Clinical recordings from all patients initiated on hemodialysis (HD) or peritoneal dialysis between January 1996 and December 2005 in the Dialysis Center of NIDNMD Paulescu, Bucharest, were collected and analyzed. Patients were classified accordingly in two groups: those who displayed EM formed the “cases” group, while the others were included in the “controls” group. Both univariate (subgroup analysis) and multivariate analyses (logistic regression, Cox regression) were used to analyze the impact of risk factors on EM outcome. Results Data from 788 patients were included in the analysis. The factors significantly associated with EM in the univariate analysis were female gender, late initiation (LI) of dialysis, old age and HD used as the first/only method. Applying the multivariate analysis, only the use of HD (OR = 4.20, p  
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-013-0589-6