AUTHOR=Li Xiang , Fan Chengjuan , Wang Chen , Zhang Yiming , Niu Lingling TITLE=Non-linear relationship between baseline fasting blood glucose and mortality in peritoneal dialysis patients, a retrospective cohort study JOURNAL=Frontiers in Medicine VOLUME=11 YEAR=2024 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1325914 DOI=10.3389/fmed.2024.1325914 ISSN=2296-858X ABSTRACT=Background

The relationship between baseline fasting blood glucose (bFBG) and mortality in peritoneal dialysis (PD) patients has been the subject of debate, with limited exploration of the non-linear relationship between bFBG and death in these patients.

Methods

This retrospective study categorized patients into four groups based on their bFBG using quartiles. Baseline clinical data at the initiation of dialysis were compared. Survival curves were plotted, and subgroup analyses were stratified by relevant covariates. To address the non-linear relationship, curve fitting and a threshold effect analysis were performed.

Results

The study included 379 PD patients with a median follow-up of 41.8 (22.6, 60.1) months. The COX proportional hazards model showed an association between bFBG and the risk of death after adjusting for confounding factors [hazard ratio (HR): 1.22, 95% CI: 1.05−1.41, P = 0.009]. Stratified analyses indicated a stable correlation between bFBG and mortality. The Kaplan-Meier curve analysis revealed significant differences in survival rates among different groups based on bFBG levels (P < 0.01). The curve fitting analysis revealed a U-shaped relationship between bFBG and mortality, with an inflection point at approximately 5.1 mmol/L.

Conclusion

Our study has demonstrated a non-linear relationship between bFBG and mortality in PD patients. Additionally, we have found that the optimal bFBG value associated with the lowest risk of mortality is approximately 5.1 mmol/L.