Diabetic Patients and Peritoneal Dialysis

Authors

  • yassine Allata 1. Department of Nephrology, Hemodialysis and Transplantation, Hassan II University Hospital, Fez, Morocco. https://orcid.org/0000-0002-0999-0640
  • Basmat Amal Chouhani 1. Department of Nephrology, Hemodialysis and Transplantation, Hassan II University Hospital, Fez, Morocco. 2. Epidemiology and Health Sciences Research Laboratory, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco. https://orcid.org/0000-0002-9687-1390
  • Ghita EL Bardi 1. Department of Nephrology, Hemodialysis and Transplantation, Hassan II University Hospital, Fez, Morocco. 2. Epidemiology and Health Sciences Research Laboratory, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco. https://orcid.org/0000-0002-2673-7137
  • Tarik Sqalli Houssaini 1. Department of Nephrology, Hemodialysis and Transplantation, Hassan II University Hospital, Fez, Morocco. 2. Epidemiology and Health Sciences Research Laboratory, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco. https://orcid.org/0000-0002-7388-288X
  • Nadia Kabbali 1. Department of Nephrology, Hemodialysis and Transplantation, Hassan II University Hospital, Fez, Morocco. 2. Epidemiology and Health Sciences Research Laboratory, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco. https://orcid.org/0000-0003-1546-5321

DOI:

https://doi.org/10.25796/bdd.v6i3.76653

Keywords:

Diabetes, mechanical complicatio, peritonitis, peritoneal dialysis, renal failure

Abstract

Full text : click on the pdf icon or https://bdd.rdplf.org/index.php/bdd/article/view/76653/72103

The prevalence of diabetes mellitus (DM) among patients requiring renal replacement therapy (RRT) has been on the rise worldwide, with DM now being the primary cause of end-stage renal disease (ESRD) in roughly one-third of RRT initiations. Although renal transplantation is the optimal treatment for ESRD, its limited availability has led to in-center hemodialysis (HD) being widely used as the default RRT modality in many countries. However, peritoneal dialysis (PD) may offer a superior option for diabetic patients due to its slower ultrafiltration rate, which can help mitigate the dialysis-induced hypotension and coronary ischemia that are associated with extracorporeal circulation during HD. Despite these advantages, unfounded concerns about technique failure and increased complication rates have discouraged some clinicians from recommending PD as a first-line RRT for diabetic patients.

We conducted a retrospective study comparing the incidence of complications and technique survival rates between diabetic and non-diabetic patients undergoing PD at a dialysis unit in Morocco. Our findings reveal that, diabetic patients undergoing PD experienced no significant difference in technique survival or incidence of complications compared to their non-diabetics. Nevertheless, only a small proportion (17.5%) of patients in our PD unit was diabetic, suggesting a need to improve access to PD for diabetic patients with ESRD.

References

Thurlow JS, Yan G, et al. Global epidemiology of end-stage kidney disease and disparities in kidney replacement therapy. Am J Nephrol. 2021;52:98-107. 10.1159/000514550. DOI: https://doi.org/10.1159/000514550

Benghanem Gharbi M, Elseviers M, Zamd M, et al. Maladie rénale chronique, hypertension, diabète et obésité dans la population adulte du Maroc : comment éviter le «sur»- et le «sous-»-diagnostic de l’IRC. Kidney Int. 2016;89:1363-71. 10.1016/j.kint.2016.02.019. DOI: https://doi.org/10.1016/j.kint.2016.02.019

Niang A, Iyengar A, Luyckx VA. Hemodialysis versus peritoneal dialysis in resource-limited settings. Curr Opin Nephrol Hypertens. 2018;27:463-471. 10.1097/MNH.0000000000000455. DOI: https://doi.org/10.1097/MNH.0000000000000455

Selby NM, McIntyre CW. Les effets cardiaques aigus de la dialyse. Semin Dial. 2007;20:220-8. 10.1111/j.1525-139X.2007.00281.x. DOI: https://doi.org/10.1111/j.1525-139X.2007.00281.x

Mathew AT, Fishbane S, Obi Y, et al. Préservation de la fonction rénale résiduelle chez les patients hémodialysés : revivre un vieux concept. Kidney Int. 2016;90:262-271. 10.1016/j.kint.2016.02.037. DOI: https://doi.org/10.1016/j.kint.2016.02.037

Cotovio P, Rocha A, Rodrigues A. Peritoneal dialysis in diabetics : there is room for more. Int J Nephrol. 2011;2011:914849. 10.4061/2011/914849. DOI: https://doi.org/10.4061/2011/914849

Wong B, Ravani P, Oliver MJ, et al. Comparaison de la survie des patients entre l’hémodialyse et la dialyse péritonéale parmi les patients éligibles pour les deux modalités. Am J Kidney Dis. 2018;71:344-351. 10.1053/j.ajkd.2017.08.028.

Site de la Direction Régionale de santé de Fès-Meknès. (2022). Consulté : 28 septembre 2022 : https://www.hcp.ma/region-fes/A-propos-de-la-direction_r8.html.

Charbonnel B, Le Feuvre C, et al. Recommandations SFC/ALFEDIAM sur la prise en charge du patient diabétique vu par le cardiologue. Diabetes Metab. 2004;30:2S2-2S8. DM-04-2004-30-2-C2-1262-3636-101019-ART1. DOI: https://doi.org/10.1016/S1262-3636(04)72798-6

Mehrotra R, Devuyst O, Davies SJ, et al. The current state of peritoneal dialysis. J Am Soc Nephrol. 2016;27:3238-3252. 10.1681/ASN.2016010112. DOI: https://doi.org/10.1681/ASN.2016010112

Andrésdóttir G, Jensen ML, Carstensen B, et al. Improved survival and renal prognosis of patients with type 2 diabetes and nephropathy with improved control of risk factors. Diabetes Care. 2014;37:1660-7. 10.2337/dc13-2036. DOI: https://doi.org/10.2337/dc13-2036

Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease : global dimension and perspectives. Lancet. 2013;382:260-72. 10.1016/S0140-6736(13)60687-X. DOI: https://doi.org/10.1016/S0140-6736(13)60687-X

Thomas MC, Cooper ME, Zimmet P. Évolution de l’épidémiologie du diabète de type 2 et des maladies rénales chroniques associées. Nat Rev Nephrol. 2016;12:73-81. 10.1038/nrneph.2015.173. DOI: https://doi.org/10.1038/nrneph.2015.173

Lindholm S, et al. Definition of metabolic syndrome in peritoneal dialysis. Perit Dial Int. 2009;29:S137-S144. https://pubmed.ncbi.nlm.nih.gov/19270203/ DOI: https://doi.org/10.1177/089686080902902S27

Blaine E, Tumlinson R, Colvin M, Haynes T, Whitley HP. Revue systématique de la littérature sur les ajustements de la dose d’insuline lors de l’initiation de l’hémodialyse ou de la dialyse péritonéale. Pharmacotherapy. 2022;42:177-187. 10.1002/phar.2659

Szeto CC, Kwan BC, Chow KM, et al. Metabolic syndrome in peritoneal dialysis patients : choice of diagnostic criteria and prognostic implications. Clin J Am Soc Nephrol. 2014;9:779-87. 10.2215/CJN.06620613. DOI: https://doi.org/10.2215/CJN.06620613

Published

2023-11-13

How to Cite

1.
Allata yassine, Chouhani BA, EL Bardi G, Sqalli Houssaini T, Kabbali N. Diabetic Patients and Peritoneal Dialysis. Bull Dial Domic [Internet]. 2023 Nov. 13 [cited 2024 Nov. 14];6(3):105-12. Available from: https://bdd.rdplf.org/index.php/bdd/article/view/76653