Elevated Blood Sugar Tied to Higher Death Risk in Peritoneal Dialysis Patients: Study

The study found that the risk of all-cause mortality increased when fasting blood glucose levels surpassed 125 mg/dL in peritoneal dialysis patients with diabetes. Additionally, there was a strong correlation between elevated FBG levels and cardiovascular death compared to other causes of death.

Peritoneal dialysis (PD) is a common treatment for patients with end-stage renal disease, but managing complications and improving survival rates remain key challenges. This study specifically focused on the role of fasting blood glucose, a marker commonly associated with diabetes, in predicting mortality risks for PD patients.

Glycemic control is essential for PD patients with diabetes. While FBG is widely used to monitor blood glucose levels, there is currently no established evidence linking FBG levels to mortality risk in this patient population. Therefore, Hyeon Seok Hwang, Kyung Hee University, College of Medicine, Seoul, Republic of Korea, and colleagues examined the connection between fasting blood glucose levels and the risk of all-cause mortality in diabetic peritoneal dialysis patients. Additionally, the study aimed to assess how FBG levels are associated with the risk of specific causes of death to determine which mortality causes are most influenced by glucose levels.

For this purpose, the researchers enrolled 3,548 diabetic peritoneal dialysis (PD) patients from the National Health Insurance Service database of Korea, covering the period from 2002 to 2018. They investigated the association between fasting blood glucose (FBG) levels and all-cause and cause-specific mortality risk.

Based on the study, the researchers revealed the following findings:

• Patients with FBG levels 80–99 mg/dL exhibited the highest survival rates, whereas those with FBG levels ≥180 mg/dL had the lowest survival rates.
• Compared with FBG levels 80–99 mg/dL, the adjusted hazard ratios for all-cause mortality significantly increased as follows: 1.02, 1.41, 1.44, and 2.05 for patients with FBG 100–124 mg/dL, FBG 125–149 mg/dL, FBG 150–179 mg/dL, and FBG ≥180 mg/dL, respectively.
• The risk for all-cause mortality also showed an increasing pattern in patients with FBG levels <80 mg/L.
• The risk of cardiovascular death significantly increased as FBG levels exceeded 125 mg/dL.
• The risk of infection-related and malignancy-related deaths did not show a significant increase with increasing FBG levels.

The study found a notable rise in the risk of all-cause mortality when fasting blood glucose levels exceeded 125 mg/dL in peritoneal dialysis patients with diabetes. Additionally, there was a significant correlation between elevated FBG levels and cardiovascular mortality compared to other causes of death.

"These findings offer crucial insights for clinicians in managing blood glucose levels in diabetic PD patients," the researchers concluded.

Reference:

Lim, S. J., Moon, J. Y., Jeong, K. H., Ko, G. J., Choi, Y. J., & Hwang, H. S. (2024). Fasting blood glucose level and risk of all-cause and cause-specific mortality in peritoneal dialysis patients. Journal of Diabetes, 16(9), e13601. https://doi.org/10.1111/1753-0407.13601