Journal Article

Fasting blood glucose level and risk of all‐cause and cause‐specific mortality in peritoneal dialysis patients

Choi, Yun Jin, Moon, Ju Young, Jeong, Kyung Hwan, Hwang, Hyeon Seok, Ko, Gang Jee, Lim, So Jin

2024

Overview

Background Glycemic control is crucial in peritoneal dialysis (PD) patients with diabetes. Although fasting blood glucose (FBG) is the most commonly used index to measure blood glucose levels, there is currently no evidence supporting the association between FBG level and mortality risk in PD patients. Methods A total of 3548 diabetic PD patients between 2002 and 2018 were enrolled from the National Health Insurance Service database of Korea. We investigated the association between FBG levels and the risk of all‐cause and cause‐specific mortality. Results Patients with FBG levels 80–99 mg/dL exhibited the highest survival rates, whereas those with FBG levels ≥180 mg/dL had the lowest survival rates. Compared with FBG levels 80–99 mg/dL, the adjusted hazard ratios and 95% confidence interval for all‐cause mortality significantly increased as follows: 1.02 (0.87–1.21), 1.41 (1.17–1.70), 1.44 (1.18–2.75), and 2.05 (1.73–2.42) for patients with FBG 100–124 mg/dL, FBG 125–149 mg/dL, FBG 150–179 mg/dL, and FBG ≥180 mg/dL, respectively. The risk for all‐cause mortality also showed an increasing pattern in patients with FBG levels <80 mg/L. The risk of cardiovascular death significantly increased as FBG levels exceeded 125 mg/dL. However, the risk of infection‐related and malignancy‐related deaths did not show a significant increase with increasing FBG levels. Conclusion There was an increase in the risk of all‐cause mortality as FBG levels exceeded 125 mg/dL in PD patients with diabetes, and the risk of cardiovascular death showed a strong correlation with FBG levels compared with other causes of death. Highlights A clear association was observed between FBG levels and the risk of all‐cause mortality in PD patients, indicating that FBG is a significant indicator for quantifying the risk of all‐cause mortality in these patients. Although a higher FBG level was significantly associated with an increased risk of cardiovascular‐related death, there was no notable increase in the risk of death from cancer or infections as the FBG levels increased.

• Publisher: Wiley Publishing Asia Pty Ltd,John Wiley & Sons, Inc,Wiley
• Subject: Adult / Aged / all‐cause mortality / Blood Glucose - analysis / Cause of Death / cause‐specific mortality / Diabetes / Diabetes Mellitus - blood / Diabetes Mellitus - mortality / Fasting - blood / fasting blood glucose / Female / Glucose / Humans / Kidney Failure, Chronic - blood / Kidney Failure, Chronic - mortality / Kidney Failure, Chronic - therapy / Male / Middle Aged / Mortality / Original / Peritoneal dialysis / Peritoneal Dialysis - mortality / Republic of Korea - epidemiology / Risk Factors / Survival Rate