Higher mortality of patients on haemodialysis with pancreatic diabetes compared to type 2-diabetes

Diabetology & Metabolic Syndrome

Georg Biesenbach¹  Gert Bodlaj¹ 

[1] From the 2nd Department of Medicine, Section Nephrology, General Hospital Linz, Austria

关键词: Outcome;    End-stage renal disease;    Pancreatic diabetes;   

Others  :  817402
DOI  :  10.1186/1758-5996-4-9

 received in 2011-10-28, accepted in 2012-03-23,  发布年份 2012

【 摘 要 】

In rare cases (1-8%) diabetic patients with end-stage renal disease (ESRD) suffer from diabetic nephropathy (dNP) due to pancreatic diabetes mellitus (PDM). Aim of this study was to investigate differences in the outcome of patients with PDM and those with type 2 diabetes.

In a retrospective study we evaluated 96 diabetic patients, who started hemodialysis (HD) in our dialysis centre (1997-2005). In 12 patients PMD was diagnosed, and 84 patients had type 2 diabetes. In both groups we compared vascular risk factors and prevalence of vascular diseases at the start of dialysis. We also evaluated incidence of malnutrition, and 5-year survival in both patient groups.

The vascular risk factors were similar in both patient groups, also the prevalence of vascular diseases at the initiation of HD was similar in both groups. In the patients with PDM the mean BMI (kg/m²) was lower (22 + 3 versus 25 + 3), and also their serum albumin was lower (2.7 + 0.3 versus 3.4 + 0.3 g/dl, p < 0.05). Four of these patients (33%) developed malnutrition (BMI < 18.5). In the patients with PDM the age adjusted 5-year survival was significantly lower (8% versus 27%, p < 0.05) than in the type 2 diabetic patients.

Conclusions in HD-treated patients with type 2 diabetes or PDM the prevalence of vascular diseases was not significantly different. The lower survival of PDM patients can be related to poor nutrition status.

【 授权许可】

   
2012 Bodlaj and Biesenbach; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Ito T, Olsuki M, Itoi T, Shimosegawa T, Funakosi A, Shiratory K, et al.: Pancreatic Diabetes in follow-up survey of chronic pancreatitis in Japan. J Gastroenterol 2007, 42:291-297.
• [2]Sjoberg RJ, Kid GS: Pancreatic diabetes mellitus. Diabetes Care 1989, 12:715-724.
• [3]Choudhuri G, Lakshmi CP, Goel A: Pancreatic diabetes. Trop Gastroenterol 2009, 30:71-75.
• [4]Hardt PD, Brendel MD, Kloer HU, Bretzel RG: Is pancreatic diabetes (type 3c diabetes) underdiagnosed and misdiagnosed? Diabetes Care 2008, 31(Suppl 2):S165-S169.
• [5]Biesenbach G, Königsrainer A, Gross C, Margreiter R: Progression of macrovascular diseases is reduced in type 1 diabetic patients after more than 5 years successful combined pancreas-kidney transplantation in comparison to kidney transplantation alone. Transpl Int 2005, 18:1054-1060.
• [6]Chattopadhyay PS, Mukhopadhyay A, Chattopadhyay R, Gupta S: Macrovascular disease is not that uncommon in fibrocalculos pancreatic diabetes. Diabetes Care 1995, 17:462-463.
• [7]Bergström J: Nutrition and mortality in hemodialysis. J Am Soc Nephrol 1995, 6:1329-1341.
• [8]Weiner DE, Tighiouart H, Elsayed F, Griffith JL, Salem DN, Levey AS, Sarnak MJ: The relationship between nontraditional risk factors outcomes in individuals with stage 3 to 4 ckd. Am J Kidney Dis 2008, 51:212-223.