Biochemical variables and survival of patients with type 1 diabetes on renal replacement therapy

Blood Purif. 2014;38(1):18-23. doi: 10.1159/000362861. Epub 2014 Sep 13.

Abstract

Background/aims: End-stage renal disease (ESRD) is one of the most serious complications of type 1 diabetes, but scarcely studied. Our aim was to estimate the association between biochemical variables and survival among these patients.

Methods: This was an incident cohort study of patients with type 1 diabetes entering chronic renal replacement therapy (RRT) in Finland 2000-2011 (n = 834). Biochemical variables were measured before the initiation of RRT. Adjusted relative risk of death according to biochemical variables was estimated by Cox regression.

Results: When adjusted for age, sex, comorbidities, and initial treatment modality of RRT, the most important predictors of death were low creatinine and albumin and high C-reactive protein.

Conclusion: Among type 1 diabetes patients entering chronic RRT, biochemical variables independently associated with survival are creatinine, albumin and C-reactive protein. They reflect the nutritional status, proteinuria, liver function, and ongoing inflammatory process. Treatment of these might improve survival.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • C-Reactive Protein / metabolism
  • Creatinine / metabolism
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / mortality
  • Diabetes Mellitus, Type 1 / surgery
  • Female
  • Humans
  • Kidney Failure, Chronic / blood*
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery
  • Liver Function Tests
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Proteinuria / blood*
  • Proteinuria / complications
  • Proteinuria / mortality
  • Proteinuria / surgery
  • Registries*
  • Renal Replacement Therapy*
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin / metabolism
  • Survival Analysis

Substances

  • Serum Albumin
  • C-Reactive Protein
  • Creatinine