Incidence and mortality of new-onset glucose disorders in peritoneal dialysis patients in China: a meta-analysis

BACKGROUND: Dialysis patients are at high risk of developing glucose metabolism disturbances (GMDs), such as diabetes mellitus (DM), impaired fast glucose (IFG), and impaired glucose tolerance (IGT). However, it is unclear about the incidence of GMDs in Chinese patients with peritoneal dialysis (PD), as well as the influence of new-onset DM (NODM) on the prognosis of PD patients. Therefore, we conducted this meta-analysis to address these issues. METHODS: A comprehensive literature search was conducted using PubMed, Embase, Web of Science, SinoMed, and CNKI database for studies that evaluated the incidence of GMDs and mortality in patients with PD. Results were expressed as hazard ratio (HR), risk ratio (RR), or estimate (ES) with 95% confidence intervals (95%CIs).Meta-analysis was performed using a fixed-effects or random-effects model to pool the estimate. RESULTS: Fifteen studies met the inclusion criteria and were included in this meta-analysis. Pooled results showed that, the incidences of NODM, NOIGT, and NOIFG were 12% (95%CI: 9, 15%; P < 0.001), 17% (95%CI: 4, 10%; P < 0.001) and 32% (95%CI: 3, 30%, P < 0.001), respectively. Compared with patients without NODM, PD patients with NODM had an increased risk of mortality (HR = 1.59, 95%CI: 1.28, 1.98; P < 0.001). There was no significant difference in the incidence of NODM between PD and hemodialysis (HD) patients (RR = 1.23, 95%CI: 0.61, 2.51; P = 0.562). CONCLUSION: Dialysis patients in China had an increased risk of developing GMDs, however, the dialysis modality did not have any significant impact on the incidence of NODM. NODM increased the mortality risk in patients undergoing PD. Thus, physicians should pay attention to the plasma glucose level in patients undergoing dialysis.