Epidemiology and Mortality of New-Onset Diabetes After Dialysis Taiwan national cohort study

doi:10.2337/dc12-2148

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Title:	Epidemiology and Mortality of New-Onset Diabetes After Dialysis Taiwan national cohort study
Authors:	Tien, Kai-Jen Lin, Zhe-Zhong Chio, Chung-Ching Wang, Jhi-Joung Chu, Chin-Chen Sun, Yih-Min Kan, Wei-Chih Chien, Chih-Chiang
Contributors:	通識教育中心
Keywords:	Ambulatory Peritoneal-Dialysis Dietary Glycemic Index Stage Renal-Disease C-Reactive Protein Sex Stratifications Womens Health Risk Mellitus Type-2 Glucose
Date:	2013-10
Issue Date:	2014-05-26 10:45:56 (UTC+8)
Publisher:	Amer Diabetes Assoc
Abstract:	OBJECTIVEWe examined the predictors and risks associated with pre-existing versus new-onset diabetes mellitus (DM) after initiation of chronic dialysis therapy in end-stage renal disease (ESRD) patients.RESEARCH DESIGN AND METHODSIn the Taiwan National Health Insurance Research Database, we examined records of ESRD patients who initiated dialysis between 1999 and 2005. Patients were followed until death, transplant, dialysis withdrawal, or 31 December 2008. Predictors of new-onset DM and mortality were calculated using Cox models.RESULTSA total of 51,487 incident dialysis patients were examined in this study, including 25,321 patients with pre-existing DM, 3,346 with new-onset DM, and 22,820 without DM at any time. Patients' age (mean SD) was 61.8 +/- 11.5, 61.6 +/- 13.7, and 56.5 +/- 16.6 years in pre-existing, new-onset DM, and without DM groups, respectively. The cumulative incidence rate of new-onset DM was 4% at 1 year and 21% at 9 years. Dialysis modality was not a risk factor for new-onset DM (peritoneal dialysis to hemodialysis hazard ratio [HR] of new-onset DM, 0.94 [95% CI 0.83-1.06]). Pre-existing DM was associated with 80% higher death risk (HR 1.81 [95% CI 1.75-1.87]), whereas the new-onset DM was associated with 10% increased death risk (HR 1.10 [95% CI 1.03-1.17]).CONCLUSIONSWhereas dialysis modality does not appear to associate with new-onset DM, both pre-existing and new-onset DM are related to higher long-term mortality in maintenance dialysis patients.
Relation:	Diabetes Care, v.36 n.10 pp.3027-3032
Appears in Collections:	[The Center For General Education] Periodical Articles

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