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Replacement Treatment with Peritoneal Dialysis in CKD—Significance of Diabetes Mellitus

Boryana Ivanova, Darina Damyanova, Svetla Staykova, Rossitsa Zorcheva

Abstract

Introduction: Diabetes mellitus (DM), as a condition with an increasing incidence, is responsible for approximately 1/2 of patients with chronic kidney disease (CKD) worldwide, and its complications often determine the prognosis and outcome for patients.

Aim: The aim of this article is to analyze the etiological and clinical significance of diabetes in the treatment of PD.

Patients and Methods: A retrospective analysis covered a total of 84 patients (39 men and 45 women, mean age 45 years +/- 15 years), observed in the Clinic of Nephrology of St. Marina University Hospital, Varna in the period 2010–2021. Method survival, survival and mortality of patients, and comorbidity were compared in 26 diabetics and 58 patients without diabetes.

Results and Discussion: In the observed group of patients with PD, 30.95% were diabetics. The results for survival of PD as a method for renal replacement therapy (RRT) did not differ significantly for diabetics and non-diabetics, respectively 57.59% and 58.93% at the end of the 5-year period after the start of PD. In the studied group of patients with diabetes, no higher mortality was found compared to patients without diabetes. In a comparative analysis, the groups of patients with and without diabetes did not differ significantly in terms of their survival at the end of the 1st and 3rd year, but the 5-year survival of diabetics was significantly lower—61.54% against 78.57% (p < 0.01). In the group of patients with diabetes, we found higher comorbidity compared to non-diabetics, which is probably the main reason for the lower survival of diabetics at 5 years. The comparative analysis showed that the clinical outcomes in the observed diabetics with PD were identical to those in non-diabetics, except for the lower 5-year survival. The establishment of equal survival of the PD method, as well as the lack of a significant difference in mortality in diabetics and non-diabetics, means that PD is a good choice for the treatment of diabetics with CKD.

Conclusion: In conclusion, the close clinical outcomes in patients with and without diabetes mellitus identify PD as an applicable and appropriate RRT for diabetics.

Keywords

CKD, renal replacement therapy (RRT), peritoneal dialysis, diabetes mellitus, diabetic nephropathy

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DOI: http://dx.doi.org/10.14748/an.v16i1.8469

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About The Authors

Boryana Ivanova
Clinic of Nephrology and Dialysis, St. Marina University Hospital, Мedical University of Varna
Bulgaria

Darina Damyanova
Clinic of Nephrology and Dialysis, St. Marina University Hospital, Мedical University of Varna
Bulgaria

Svetla Staykova
Clinic of Nephrology and Dialysis, St. Marina University Hospital, Мedical University of Varna
Bulgaria

Rossitsa Zorcheva
Clinic of Nephrology and Dialysis, St. Marina University Hospital, Мedical University of Varna
Bulgaria

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