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Background and Aims Diabetes in recent years is climbing up as the number one cause of chronic kidney disease (CKD). Clinical statistics suggest that Diabetics on peritoneal dialysis (PD) tend to have a poorer prognosis than others. Thus, the aim of this study is to determine the clinical outcomes and to evaluate the survival rates as well as the predictors of mortality among this group. Method It‘s a retrospective study carried out in the nephrology Department of Fattouma Bourguiba Hospital (Monastir, Tunisia) from 1990 to 2017 including 304 PD patients. We compared two groups: diabetic and non diabetic patients in term of survival and factors in correlation. Results A total of 110 diabetic versus 194 non diabetic patients were reported. The mean age of diabetic group was 55.14 ± 15 years with a sex ratio 2.33 (men/women). In addition to diabetes, comorbid diseases included hypertension (47.3%) and cardiopathy (32.7%). The mean Charlson score of diabetic group was 5.22±1.5 versus 2.72±1.23 in the other group. A total of 62.7% (n=69) of the patients performed PD with the help of another person mostly a member of the family. The PD modality often used was CAPD (71%). Only six patients made a compulsory choice to begin PD due to vascular access while sixty diabetics chose PD to maintain autonomy (54.5%). During the follow-up period, transfers to hemodialysis (40.9%) and death (53.6%) were the most common cause of withdrawal from PD. In total, 45 patients were transferred to hemodialysis because of infectious complications (31%), Ultrafiltration failure (31%), catheter dysfunction (27%), and psychological intolerance (11%). The death was unrelated to PD in 83% of cases mostly due to considerable burden of cardiovascular events (23 patients). The median survival of the diabetic patients was 15.8 years versus 20.8 years in non diabetic ones with significant difference between the 2 groups (p=0.0001). Diabetes was associated with worse prognosis (OR:147, p=0.0001). The median survival adjusted to the diabetes group was 180 months. Kaplan–Meier analysis showed that diabetes was associated with a significant increase in mortality (p=0.006). Global median survival of the technique was estimated to 68 months (95%, IC [47 ,90]), and it was correlated to the presence or the absence of diabetes. In fact, the technique survival among diabetic patients was estimated to 80% after 12 years and 25% after 20 years whereas, in the other group it approaches 90% and 35% respectively. Conclusion This study confirms the pejorative impact of diabetes in the technique and patient survival in DP. So, it stresses the importance of organizing appropriate care upstream to prevent the development of cardiovascular morbidities and infectious complications in DP.

Background and Aims physical activity is generally impaired in the chronic hemodialysis patient. Studies confirm the benefit of maintaining or improving physical activity in these patients. For this reason, our study aims to assess physical inactivity in chronic hemodialysis patients using a physical activity score: DIJON score and to identify the factors linked to a decrease in physical activity . Method this is a descriptive and analytical cross-sectional study carried out at the hemodialysis center of Fattouma Bourguiba hospital in Monastir. We used the DIJON questionnaire to measure physical activity: daily activities, sports or leisure. The reference values for the level of physical activity are 0-10 (low), 10-20 (medium); and 20-30 (high). Results our study included 71 patients. The middle age was 46.62 + - 15.34 years. 69% of patients were male. The overall physical activity level was high at 22.75 + -1.99 in 28.2% of patients, medium at 13.75 + -3.65 in 33.8% of patients and low at 5.56 + -2.91 in 38% of hemodialysis patients. Analysis in multiple linear regression showed that the variables that explained the DIJON score in our population are in order of contribution: pre-dialytic uremia (β = 0.433; t = 2.99; p = 0.005), cardiac diseases(β = 0.305; t = 2.074; p = 0.044), the KT/V ratio (β = -. 858; p = -1.915; p = 0.063), the PRU (β = 1.21; t = 1.885; p = 0.066) , anemia (β = 0.211; t = 1.704; p = 0.096), comorbidity evaluated by Charlson score (β = -. 461; t = -1.414; p = 0.165). Conclusion our results showed that the level of physical activity is linked to many factors, some of which are modified. So, prescribing an adapted and personalized program will improve the prognosis and the quality of life of our patients.