Peritoneal dialysis in diabetes patients.

Introduction: Peritoneal dialysis (PD) is a renal replacement therapy (RRT) in end stage kidney disease patients with several advantages and disadvantages.

Aim: To evaluate the epidemiological, clinical, biological and outcome of diabetic patients in PD in our service and to determine the factors influencing overall survival and technique.

Methods: This was a retrospective study that included 90 diabetic patients supported on PD in our Department of Nephrology and Internal Medicine A in Charles Nicolle Hospital of Tunis from 1983 to 2016.

Results: There were 90 patients with mean age of 57 years. The sex ratio M/W was 1.3. Diabetes was type 2 in 84.44%. Complications were decreased ultrafiltration (26.66%), displacement of the catheter (20%), umbilical hernia (3.33%), malnutrition (2.22%) and peritonitis (45.55%). The number of peritonitis was 1 episode every 38.64 patient months. Transfer to hemodialysis was indicated in 37.78% of cases. Death occurred in 33 patients. Causes were cardiovascular (21.11%), septic shock (10%) and complicated peritonitis (5.55%). A statistically significant correlation was found between patient survival and death from cardiovascular events (p = 0.048), type 2 diabetes and high peritoneal permeability (p = 0.033) and technical survival and systolic arterial pressure> 139.5mmHg (p = 0.01). Overall survival at 5 years was 66% and technical survival was 28%.

Conclusion: PD is an interesting way of RRT in diabetic patients. Good control of diabetes complications and those of PD technique is essential to increase survival.