Fasting blood glucose level and all-cause mortality in peritoneal dialysis patients

Abstract Glycemic control is particularly important in peritoneal dialysis (PD) patients with diabetes. Although fasting blood glucose (FBG) is the most commonly used index to measure blood glucose levels, there is currently no conclusive evidence to establish the target FBG level for PD patients. A total of 3,548 patients with diabetes who underwent PD between 2002 and 2018 were enrolled using data from the National Health Insurance Service database of Korea. We investigated the association between time-varying FBG levels and the risk of all-cause mortality. During an average follow-up period of 6.55 years, a total of 1,366 mortality events were identified. Patients with FBG levels 80–99 mg/dL exhibited the highest survival rates, while those with FBG levels ≥ 180 mg/dL had the lowest survival rates. Compared to patients with FBG levels of 80–99 mg/dL, the adjusted hazard ratios (HR) for all-cause mortality significantly increased with an elevation in FBG levels. Additionally, the HR for all-cause mortality was higher in patients with FBG levels < 80 mg/dL compared to those with FBG levels of 80–99 mg/dL. A J-shaped association was observed between FBG levels and the risk of all-cause mortality, which was the lowest at FBG 80–124 mg/dL in PD patients with diabetes.