Bidirectional association between ESRD dialysis and diabetes: National cohort study

doi:10.1371/journal.pone.0173785

CNU IR > Pharmacy and Science > Dept. of Pharmacy > Periodical Articles > Item 310902800/31759

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Title:	Bidirectional association between ESRD dialysis and diabetes: National cohort study
Authors:	Chu, Yeh-Wen Wu, Wen-Shiann Hsu, Chen-Fang Wang, Jhi-Joung Weng, Shih-Feng Chien, Chih-Chiang
Contributors:	Chi Mei Med Ctr, Dept Nephrol Chi Mei Med Ctr, Dept Cardiol Chia Nan Univ Pharm & Sci, Dept Pharm Chi Mei Med Ctr, Dept Pediat Chi Mei Med Ctr, Dept Med Res Kaohsiung Med Univ, Dept Healthcare Adm & Med Informat
Keywords:	Stage Renal-Disease Glucose-Intolerance Insulin-Resistance Mortality Taiwan Hemodialysis Mellitus Impact
Date:	2017-03-15
Issue Date:	2018-11-30 15:55:38 (UTC+8)
Publisher:	Public Library Science
Abstract:	Background Diabetes is associated with development of end-stage renal disease (ESRD) dialysis, but it is not clear whether ESRD dialysis is a risk factor for new-onset diabetes (NODM). Methods Using the Taiwan National Health Insurance Research Database, we designed two cohort studies to determine the association between dialysis and diabetes. Analysis 1 estimated the hazard ratios (HR) of ESRD dialysis in 20,585 patients with type 2 diabetes (T2DM) and 82,340 gender- and age-matched controls without diabetes. Analysis 2 estimated the HRs of NODM in 18,489 ESRD patients undergoing dialysis and 73,956 gender- and age matched controls without ESRD dialysis. The follow-up period was from 2000 to date of endpoint, the date of death, or December 31, 2008. Cox proportional models were used to estimate the relative hazards. Results In analysis 1, the incidence of ESRD dialysis was higher in the T2DM cohort than in the non diabetes cohort (6.78 vs. 0.61 per 1,000 person-years; HR: 7.97; 95%X1: 7.05-8.00). In analysis 2, the incidence of NODM was higher in the ESRD dialysis cohort than in the without-ESRD dialysis cohort (22.84 vs. 13.99 per 1,000 person-years; HR: 1.40; 95% CI: 1.34-1.47). Conclusions ESRD dialysis and diabetes were bidirectionally associated. The relationship between T2DM and incident ESRD dialysis was much stronger than between ESRD dialysis and NODM. Further studies are needed to determine the mechanism of ESRD dialysis-related NODM.
Relation:	Plos One, v.12, n.3, e0173785
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles

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