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Bidirectional association between ESRD dialysis and diabetes: National cohort study
Yeh-Wen Chu1, Wen-Shiann Wu2,3, Chen-Fang Hsu4
1Department of Nephrology, Chi-Mei Medical Center, Tainan, Taiwan.
Plos One
|March 16, 2017
Summary
End-stage renal disease (ESRD) dialysis is a risk factor for new-onset diabetes mellitus (NODM), though less so than diabetes is for ESRD dialysis. These conditions show a bidirectional relationship.
Area of Science:
- Nephrology
- Endocrinology
- Epidemiology
Background:
- Diabetes mellitus (DM) is a known risk factor for end-stage renal disease (ESRD) requiring dialysis.
- The potential for ESRD dialysis to be a risk factor for new-onset diabetes mellitus (NODM) remains unclear.
Purpose of the Study:
- To investigate the bidirectional association between ESRD dialysis and diabetes.
- To determine if ESRD dialysis increases the risk of developing NODM.
Main Methods:
- Two cohort studies utilizing the Taiwan National Health Insurance Research Database.
- Analysis 1: Hazard ratios (HR) of ESRD dialysis in patients with type 2 diabetes (T2DM) vs. controls.
- Analysis 2: HRs of NODM in patients undergoing ESRD dialysis vs. controls.
Main Results:
- T2DM significantly increased the risk of ESRD dialysis (HR: 7.97).
- ESRD dialysis also increased the risk of NODM (HR: 1.40).
- The association between T2DM and incident ESRD dialysis was substantially stronger than the association between ESRD dialysis and NODM.
Conclusions:
- ESRD dialysis and diabetes exhibit a bidirectional relationship.
- While both conditions influence each other, diabetes poses a greater risk for developing ESRD dialysis.
- Further research is required to elucidate the mechanisms underlying ESRD dialysis-related NODM.
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