Comparing risk of new onset diabetes mellitus in chronic kidney disease patients receiving peritoneal dialysis and hemodialysis using propensity score matching

Che-Yi Chou; Chih-Chia Liang; Huey-Liang Kuo; Chiz-Tzung Chang; Jiung-Hsiun Liu; Hsin-Hung Lin; I-Kuan Wang; Ya-Fei Yang; Chiu-Ching Huang

doi:10.1371/journal.pone.0087891

Comparing risk of new onset diabetes mellitus in chronic kidney disease patients receiving peritoneal dialysis and hemodialysis using propensity score matching

PLoS One. 2014 Feb 4;9(2):e87891. doi: 10.1371/journal.pone.0087891. eCollection 2014.

Authors

Che-Yi Chou¹, Chih-Chia Liang², Huey-Liang Kuo¹, Chiz-Tzung Chang¹, Jiung-Hsiun Liu¹, Hsin-Hung Lin¹, I-Kuan Wang¹, Ya-Fei Yang¹, Chiu-Ching Huang¹

Affiliations

¹ Kidney Institute and Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan ; Department of Medicine, China Medical University, Taichung, Taiwan.
² Kidney Institute and Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.

Abstract

Chronic kidney disease (CKD) patients are at risk for developing new-onset diabetes mellitus (NODM) even after hemodialysis (HD) and peritoneal dialysis (PD) treatment. It is not clear if the incidence for NODM is different in CKD patients receiving HD and PD. This study compared the risk of NODM in PD patients and HD patients.

Methods: All HD and PD patients in Taiwan Renal Registry Database from 1997 to 2005 were included and all patients were followed to December 31, 2008. The risk of NODM was analyzed in PD patients and propensity score matched HD patients using logistic regression for early type NODM (< = 6 months after dialysis) and Cox regression for late type NODM (>6 months after dialysis).

Results: A total of 2548 PD patients and 10192 HD patients who had no diabetes on the initiation of dialysis were analyzed. The incidence for NODM was 3.7 per 100 patient/year for HD and 2.4 for PD patients. HD patients are more at risk for developing early type NODM (p<0.001) with an adjusted odds ratio of 1.41 [95% confidence interval (CI) 1.12-1.78)]. HD patients are more at risk for late type NODM (p<0.001) with an adjusted hazard ratio of 2.01 (95% CI: 1.77-2.29). Patient's age was negatively associated with risk of early type of NODM (p<0.001) but positively associated with risk of late type NODM (p<0.001).

Conclusions: Chronic kidney disease patients receiving hemodialysis are more at risk for developing new-onset diabetes mellitus compared to those receiving peritoneal dialysis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Diabetes Mellitus / epidemiology*
Diabetes Mellitus / etiology*
Diabetes Mellitus / mortality
Female
Humans
Incidence
Male
Middle Aged
Odds Ratio
Peritoneal Dialysis
Propensity Score
Renal Dialysis
Renal Insufficiency, Chronic / complications*
Renal Insufficiency, Chronic / mortality
Renal Insufficiency, Chronic / therapy
Risk

Grants and funding

This study was supported by clinical research grants from China Medical University Hospital (DMR-97-035, DMR-98-018, DMR-99-027) and grants from Bureau of Health Promotion, Department of Health (DOH 97-HP-1103). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.