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Increased Peritoneal Protein Loss and Diabetes: Is There a Link?

Increased peritoneal protein loss has been associated with the fast transport of small molecules, diabetes mellitus (DM), and a reduced survival in patients on peritoneal dialysis (PD), although some studies did not confirm the association with survival. In this single-center retrospective study, we...

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Autores principales: Bontić, Ana, Gajić, Selena, Bjelić, Danka, Pavlović, Jelena, Stanković-Popović, Verica, Radović, Milan, Kezić, Aleksandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10094752/
https://www.ncbi.nlm.nih.gov/pubmed/37048753
http://dx.doi.org/10.3390/jcm12072670
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author Bontić, Ana
Gajić, Selena
Bjelić, Danka
Pavlović, Jelena
Stanković-Popović, Verica
Radović, Milan
Kezić, Aleksandra
author_facet Bontić, Ana
Gajić, Selena
Bjelić, Danka
Pavlović, Jelena
Stanković-Popović, Verica
Radović, Milan
Kezić, Aleksandra
author_sort Bontić, Ana
collection PubMed
description Increased peritoneal protein loss has been associated with the fast transport of small molecules, diabetes mellitus (DM), and a reduced survival in patients on peritoneal dialysis (PD), although some studies did not confirm the association with survival. In this single-center retrospective study, we investigated the relationship of baseline peritoneal albumin and protein loss with transport status, comorbidities including DM, and survival in 106 incident PD patients during the period of July 2005–June 2014. Five-year survival rate was determined using Cox-regression analysis. There were not significant differences in D/Pcr or peritoneal protein and albumin loss between diabetics and non-diabetics. In the group of 66 non-diabetics, high and high-average transporters for creatinine had higher values for both peritoneal protein (11.85 ± 6.77 vs. 7.85 ± 4.36 g/day; p = 0.002) and albumin (5.03 ± 2.32 vs. 3.72 ± 1.54 g/day; p = 0.016) loss as compared to slow transporters. However, in the group of 40 diabetics, this association was not observed. Upon multivariable regression analysis, the independent association of D/PCr with peritoneal albumin (β = 0.313; p = 0.008) and protein (β = 0.441; p = 0.001) loss was found only in non-diabetics in whom ultrafiltration also appeared as a significant predictor of peritoneal protein loss (β = 0.330; p = 0.000). A high comorbidity grade, older age, and low serum albumin were associated with mortality, but both peritoneal protein and albumin loss as well as D/Pcr were not determinants of survival. Baseline peritoneal protein and albumin loss was not associated with DM and did not predict survival. The clinical significance of the absence of association between fast peritoneal transport status and peritoneal protein flux in diabetics should be evaluated in a prospective study comprising a greater number of diabetics with evaluation of overhydration as a main inducing variable of protein leak.
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spelling pubmed-100947522023-04-13 Increased Peritoneal Protein Loss and Diabetes: Is There a Link? Bontić, Ana Gajić, Selena Bjelić, Danka Pavlović, Jelena Stanković-Popović, Verica Radović, Milan Kezić, Aleksandra J Clin Med Article Increased peritoneal protein loss has been associated with the fast transport of small molecules, diabetes mellitus (DM), and a reduced survival in patients on peritoneal dialysis (PD), although some studies did not confirm the association with survival. In this single-center retrospective study, we investigated the relationship of baseline peritoneal albumin and protein loss with transport status, comorbidities including DM, and survival in 106 incident PD patients during the period of July 2005–June 2014. Five-year survival rate was determined using Cox-regression analysis. There were not significant differences in D/Pcr or peritoneal protein and albumin loss between diabetics and non-diabetics. In the group of 66 non-diabetics, high and high-average transporters for creatinine had higher values for both peritoneal protein (11.85 ± 6.77 vs. 7.85 ± 4.36 g/day; p = 0.002) and albumin (5.03 ± 2.32 vs. 3.72 ± 1.54 g/day; p = 0.016) loss as compared to slow transporters. However, in the group of 40 diabetics, this association was not observed. Upon multivariable regression analysis, the independent association of D/PCr with peritoneal albumin (β = 0.313; p = 0.008) and protein (β = 0.441; p = 0.001) loss was found only in non-diabetics in whom ultrafiltration also appeared as a significant predictor of peritoneal protein loss (β = 0.330; p = 0.000). A high comorbidity grade, older age, and low serum albumin were associated with mortality, but both peritoneal protein and albumin loss as well as D/Pcr were not determinants of survival. Baseline peritoneal protein and albumin loss was not associated with DM and did not predict survival. The clinical significance of the absence of association between fast peritoneal transport status and peritoneal protein flux in diabetics should be evaluated in a prospective study comprising a greater number of diabetics with evaluation of overhydration as a main inducing variable of protein leak. MDPI 2023-04-03 /pmc/articles/PMC10094752/ /pubmed/37048753 http://dx.doi.org/10.3390/jcm12072670 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bontić, Ana
Gajić, Selena
Bjelić, Danka
Pavlović, Jelena
Stanković-Popović, Verica
Radović, Milan
Kezić, Aleksandra
Increased Peritoneal Protein Loss and Diabetes: Is There a Link?
title Increased Peritoneal Protein Loss and Diabetes: Is There a Link?
title_full Increased Peritoneal Protein Loss and Diabetes: Is There a Link?
title_fullStr Increased Peritoneal Protein Loss and Diabetes: Is There a Link?
title_full_unstemmed Increased Peritoneal Protein Loss and Diabetes: Is There a Link?
title_short Increased Peritoneal Protein Loss and Diabetes: Is There a Link?
title_sort increased peritoneal protein loss and diabetes: is there a link?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10094752/
https://www.ncbi.nlm.nih.gov/pubmed/37048753
http://dx.doi.org/10.3390/jcm12072670
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