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Table 3 Mortality of diabetic PD patients

From: Comparison of peritoneal dialysis and hemodialysis as first renal replacement therapy in patients with end-stage renal disease and diabetes: a systematic review

Study/year PD patients with diabetes HD patients with diabetes Confounding factors or factors used for calculating the propensity score Analysis method Effect measure Results
Kim 2017 3996 12,190 Age, sex, NHI, comorbidity (MI, CHF, PAD, cerebrovascular disease, chronic pulmonary disease, peptic ulcer disease, and liver disease), and CCI Cox proportional hazards model Hazard ratio All diabetic patients: 1.27 (1.19–1.35)
Tamayo Isla 2016 13 22 Age, albumin, cholesterol, and hemoglobin Cox proportional hazards model Hazard ratio Diabetic PD patients: 4.99 (2.13–11.71)
Diabetic HD patients: 1.02 (0.43–2.50)
(Reference: non-diabetic HD patients)
Nesrallah 2016 768 768 Age, sex, race, smoking, alcohol, drugs, private coverage, ESRD start date, duration of ESRD, weight, prior transplant, comorbidities (cancer, hypertension, CHF, cerebrovascular disease, peripheral vascular disease, chronic obstructive pulmonary disease, and diabetes), and laboratory values (albumin and hemoglobin) Cox proportional hazards model (propensity-matched analysis) Hazard ratio All diabetic patients: 1.16 (0.99–1.39)
(Reference: diabetic patients with home daily HD)
Lee 2016 265 637 Age, sex, modified CCI, comorbid disease (CAD, PAD, CVA, and CHF), smoker, SBP, DBP, BMI, HbA1c, white blood cells, hemoglobin, BUN, creatinine, albumin, calcium, phosphorous, hs-CRP, ESA, and RRF Cox proportional hazards model (propensity-matched analysis) Hazard ratio All diabetic patients: 0.65 (0.47–0.90)
HbA1c <8.0%: 0.59 (0.37–0.93) (n = 398)
HbA1c ≥8.0%: 1.43 (0.47–2.81) (n = 72)
Marshall 2016 7271 14,309 Age, sex, ethnicity, primary kidney disease, eGFR calculated using MDRD study equation at dialysis therapy initiation, late referral for nephrology predialysis care, diabetes mellitus (none, type 1, and type 2), BMI, medical comorbid conditions (CAD, peripheral vascular disease, cerebrovascular disease, and chronic lung disease), current smoking, and country/state at dialysis therapy initiation Cox proportional hazards model Hazard ratio All diabetic patients: 1.17 (1.11–1.25)
(Reference: diabetic patients with conventional facility HD)
Wang 2016 648 647 Year of stroke diagnosis, year of dialysis initiation, age, sex, and comorbidities (CAD, CHF, cancer, hyperlipidemia, hypertension, diabetes, atrial fibrillation, stroke, chronic hepatitis, and COPD) Cox proportional hazards model (propensity-matched analysis) Hazard ratio All diabetic patients: 1.22 (1.05–1.43)
Waldum-Grevbo 2015 200 209 Age, sex, county, primary cause of ESRD, comorbidities (diabetes mellitus, LVH, established heart disease, PAD, CVD, and previous malignancy), eGFR, hemoglobin, serum albumin, number of antihypertensive drugs, use of statins, ESA, vitamin D supplementation, candidate for future transplantation, and late referral (knowledge of patients < 4 months prior to start of dialysis) Cox proportional hazards model (propensity-matched analysis) Hazard ratio 2-year mortality (as-treated): 1.20 (0.76–1.91)
2-year mortality (intention-to-treat): 1.22 (0.80–1.86)
5-year mortality (as-treated): 0.99 (0.69–1.42)
5-year mortality (intention-to-treat): 0.90 (0.65–1.25)
Yang 2015 172 426 Not described Cox proportional hazards model (propensity-matched analysis) Hazard ratio Not described
Kim 2015 3658 11,154 Age, sex, NHI (vs. Medical Aid), diabetes, comorbidities other than diabetes, including any CVD, MI, CHF, PAD, CVA, chronic pulmonary disease, connective tissue disease, peptic ulcer disease, liver disease, and cancer Multivariate Poisson regression analysis Adjusted relative risk All diabetic patients: 1.29 (1.19–1.40)
Marshall 2015 ? ? Age, sex, ethnicity, primary kidney disease, eGFR calculated using MDRD Study equation at dialysis therapy initiation, late referral for nephrology predialysis care, diabetes mellitus (none, type 1, and type 2), BMI, medical comorbid conditions (CAD, peripheral vascular disease, cerebrovascular disease, and chronic lung disease), current smoking, and country/state at dialysis therapy initiation Cox proportional hazards model Hazard ratio Not described
Ryu 2015 ? ? Age, sex, healthcare security system, dialysis modality, and modified CCI Cox proportional hazards model Hazard ratio Age ≥ 65: 1.32 (1.11–1.54)
Age < 65: 1.08 (0.90–1.28)
Marshall 2014 4381 4378 Not described Cox proportional hazards model Hazard ratio All diabetic patients: 1.15 (1.03–1.29)
Follow-up < 3 years: 0.95 (0.83–1.09)
Follow-up > 3 years: 1.54 (1.30–1.82)
Kim 2014 3996 12,190 Age, sex, type of insurance (NHI versus Medical Aid), and the presence or absence of a variety of clinical and coexisting conditions (diabetes mellitus, MI, CHF, CVA, PAD, chronic pulmonary disease, liver disease, peptic ulcer disease, and cancer) Cox proportional hazards model (propensity-matched analysis) Hazard ratio All diabetic patients: 1.27 (1.19–1.35)
Age > 55: 1.35 (1.22–1.48) (n = 4467)
Age ≤ 55: 0.97 (0.82–1.16) (n = 2820)
Heaf 2014 916 1822 First dialysis modality (PD, HD), cohort (according to date of dialysis initiation: 1990–1994, 1995–1999, 2000–2004, 2005–2010), patient age at date of dialysis initiation (categorized into 0-, 60-, 70-, and 80-), sex, renal diagnosis, CCI (categorized into 0, 1–2, ≥ 3), and type of ESRD initiation (early and routine, late and acute, other) Cox proportional hazards model Hazard ratio Diabetes (1990–99): 0.97 (0.84–1.12)
Diabetes (2000–10): 0.86 (0.75–0.97)
Diabetes and ≥ 65 years (1990–1999): 1.00 (0.77–1.29)
Diabetes and ≥ 65 years (2000–2010): 0.85 (0.71–1.01)
Mircescu 2014 194 1246 Age, sex, primary renal disease, and dialysis modality Cox proportional hazards model Hazard ratio Age 18–60 years: 1.73 (1.14–2.62)
Age > 60 years: 0.99 (0.66–1.49)
  1. Abbreviations: HD hemodialysis, PD peritoneal dialysis, NHI National Health Insurance, MI myocardial infarction, CHF congestive heart failure, PAD peripheral artery disease, CCI Charlson comorbidity index, ESRD end-stage renal disease, CAD coronary artery disease, CVA cerebrovascular accident, SBP systolic blood pressure, DBP diastolic blood pressure, BMI body mass index, HbA1c hemoglobin A1c, BUN blood urea nitrogen, hs-CRP high sensitive C-reactive protein, ESA erythropoiesis-stimulating agent, RRF residual renal function, eGFR estimated glomerular filtration rate, MDRD Modification of Diet in Renal Disease, COPD chronic obstructive pulmonary disease, CVD cardiovascular disease