The Impact of Type 2 Diabetes on Mortality in End-Stage Renal Disease Patients Differs between Genders

Vol. 112, No. 4, 2009

Free Abstract Article (Fulltext) Article (PDF 234 KB)

Original Paper

The Impact of Type 2 Diabetes on Mortality in End-Stage Renal Disease Patients Differs between Genders
A. Karamé^{a, b}, M. Labeeuw^{a, b}, P. Trolliet^a, A. Caillette-Beaudoin^c, R. Cahen^a, R. Ecochard^{d, e}, R. Galland^c, P. Hallonet^c, C. Pouteil-Noble^{a, b}, E. Villar^a

^aNephrology and Renal Transplantation, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite,
^bUniversité de Lyon-1, Villeurbanne,
^cCentre Associatif Lyonnais de Dialyse, Lucien Hussel Hospital, Vienne, and
^dDepartment of Biostatistics, Hospices Civils de Lyon, and
^eUMR CNRS 5558, Université de Lyon-1, Lyon, France

Address of Corresponding Author

Nephron Clin Pract 2009;112:c268-c275 (DOI: 10.1159/000224794)

Key Words

Dialysis
End-stage renal disease
Type 2 diabetes mellitus
Survival, gender

Abstract

Background/Aims: In diabetics with end-stage renal disease (ESRD), risk of death has been reported to be non-constant after the first dialysis, and different outcomes have been observed between genders. We assessed the impact of type 2 diabetes (T2DM) on mortality in dialysis regarding its differential effect by gender using time-dependent analyses. Methods: All T2DM and non-diabetic (no-DM) patients who started dialysis in two renal units in Lyon, France, between January 1, 1995, and December 31, 2007, were included. In multivariate analyses, the Cox model and Shoenfeld residual approach were used to assess the effect of T2DM on dialysis mortality by gender. Results: We included 235 T2DM (males: 57.9%) and 480 no-DM (males: 65.6%) patients. In males, the adjusted hazard ratio (aHR) for death in T2DM versus no-DM was 0.83 (p = 0.20) and was constant over time after the first renal replacement therapy (RRT) (p = 0.88). In females, aHR for death in T2DM versus no-DM patients was not constant over time (p = 0.002). It was 0.64 (p = 0.13) within the first year after the first RRT and 2.10 (p = 0.002) after the first year. Evolutions with time of these aHR by gender were significantly different (p = 0.009). Conclusions: T2DM was associated with death only in females. This association was not constant over time after the first dialysis.

Author Contacts

Emmanuel Villar, MD, PhD
Service de Néphrologie, Dialyse et Transplantation Rénale
Centre Hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet
FR–69495 Pierre-Bénite Cedex (France)
Tel. +33 4 7267 8702, Fax +33 4 7267 8710, E-Mail emmanuel.villar@chu-lyon.fr

Article Information

The interpretation of reported data is the responsibility of the authors and in no way should be seen as an official interpretation of the Renal Epidemiology and Information Network Registry. The results presented in this paper have not been published previously as a whole or in part, except in abstract form at the 9th Congress of the Société de Néphrologie and the Société Francophone de Dialyse in Lyon, France, 2007 (abstract O53), and at the 45th ERA-EDTA Congress in Stockholm, Sweden, 2008 (abstracts MP431 and MP433).

Received: November 11, 2008
Accepted: January 23, 2009
Published online: June 16, 2009
Number of Print Pages : 8
Number of Figures : 2, Number of Tables : 3, Number of References : 33

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