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