﻿<?xml version="1.0" encoding="UTF-8"?>
<ArticleSet>
  <Article>
    <Journal>
      <PublisherName>Society of Diabetic Nephropathy Prevention</PublisherName>
      <JournalTitle>Journal of Nephropathology</JournalTitle>
      <Issn>2251-8363</Issn>
      <Volume>6</Volume>
      <Issue>2</Issue>
      <PubDate PubStatus="ppublish">
        <Year>2017</Year>
        <Month>04</Month>
        <DAY>01</DAY>
      </PubDate>
    </Journal>
    <ArticleTitle>Clinical outcomes and quality of life in hemodialysis diabetic patients versus non-diabetics</ArticleTitle>
    <FirstPage>81</FirstPage>
    <LastPage>89</LastPage>
    <ELocationID EIdType="doi">10.15171/jnp.2017.14</ELocationID>
    <Language>EN</Language>
    <AuthorList>
      <Author>
        <FirstName>Tayebeh</FirstName>
        <LastName>Soleymanian</LastName>
      </Author>
      <Author>
        <FirstName>Zeinab</FirstName>
        <LastName>Kokabeh</LastName>
      </Author>
      <Author>
        <FirstName>Rozita</FirstName>
        <LastName>Ramaghi</LastName>
      </Author>
      <Author>
        <FirstName>Alireza</FirstName>
        <LastName>Mahjoub</LastName>
      </Author>
      <Author>
        <FirstName>Hassan</FirstName>
        <LastName>Argani</LastName>
      </Author>
    </AuthorList>
    <PublicationType>Journal Article</PublicationType>
    <ArticleIdList>
      <ArticleId IdType="doi">10.15171/jnp.2017.14</ArticleId>
    </ArticleIdList>
    <History>
    </History>
    <Abstract>Background: Diabetes is the leading cause of end stage renal disease (ESRD) worldwide. Objectives: We compared the clinical outcomes in diabetic patients on hemodialysis (HD) with non-diabetics. Patients and Methods: Adult maintenance HD patients (N= 532) from 9 HD facilities were enrolled to this prospective cohort study in September 2012. Causes of death, hospitalization, and HD exit were recorded in a median 28 months follow up period. Results. Forty-one percent of patients were diabetic. Diabetic patients compared to non-diabetics had significantly higher age (62.2 ± 11.2 versus 53.1 ± 16.7 years), lower dialysis duration (median: 23 versus 30 months), more cardiovascular comorbidities (64% versus 28%) , higher C-reactive protein (CRP) levels (median: 3.80 versus 2.25 mg/L), lower serum albumin (3.86 ± 0.35 versus 3.93 ± 0.35 g/dL), lower intact parathyroid hormone (iPTH) (median: 272 versus 374 ρg/mL), higher serum triglyceride (167 ± 91 versus 139 ± 67 mg/dL) and low density lipoprotein (LDL) (82.5 ± 24.5 versus 77.5 ± 23.8 mg/dL), and worse short form health survey (SF36) score (45.7 ± 20.9 versus 52.7 ± 20.5). Annual admission rate was higher in diabetics (median: 0.86 versus 0.43) and diabetic foot involved 16% of their admissions. Transplantation rate was 4 and 9 per 100 patient years in diabetics and non-diabetics, respectively. Death rate was two folds higher in diabetics (24 versus 12 per 100 patient years). Cardiovascular diseases ( ± infections/other causes) comprised 80.5% of death in diabetics and 54.5% in non-diabetics. In Cox regression proportional hazard multivariate analysis, hazard risk of death in diabetics was 1.9 times higher than non-diabetics. Conclusions: Clinical outcomes and health related quality of life (HRQOL) are much worse in diabetic compared to non-diabetic HD patients mainly due to more frequent of cardiovascular diseases (CVDs).</Abstract>
    <ObjectList>
      <Object Type="keyword">
        <Param Name="value">Hemodialysis</Param>
      </Object>
      <Object Type="keyword">
        <Param Name="value">Patient outcomes</Param>
      </Object>
      <Object Type="keyword">
        <Param Name="value">Diabetes mellitus</Param>
      </Object>
      <Object Type="keyword">
        <Param Name="value">Quality of life</Param>
      </Object>
      <Object Type="keyword">
        <Param Name="value">Cardiovascular disease</Param>
      </Object>
    </ObjectList>
  </Article>
</ArticleSet>