Endocrine Abstracts

Diabetic nephropathy is the most common cause of end-stage kidney disease (ESKD) among patients undergoing peritoneal dialysis (PD). This audit aimed to evaluate diabetes management among patients with diabetes on PD in University Hospital Waterford, based on guidelines from the Joint British Diabetes Societies (JBDS) for Inpatient Care Group. We conducted a retrospective review of 42 patients established on PD in April 2025. Data were collected from the renal electronic health record (eMed). Of 42 patients on PD, 36% have a history of diabetes. 67% had type two diabetes mellitus (T2DM) while 33% had type one diabetes mellitus (T1DM). All had DM for more than 5 years. The median age was 67 years (IQR=29). 87% had ESKD attributed to diabetic nephropathy. 47% had dual aetiology, namely hypertensive disease, ischaemic nephropathy or multiple myeloma. The median time on PD was 25 months. The mean HbA1c was 57 mmol/l/mol. 93% had HbA1c check within the prior 3 months. 47% had urine albumin:creatinine ratio checked within the past year. 80% of patients with T2DM were on linagliptin. One patient was on SGLT-2 inhibitor and two patients were on gliclazide. Five patients were on insulin therapy. Gliptins and insulin are the recommended therapies for patients with DM on dialysis and this audit found that SGLT-2 inhibitors and gliclazide were also used. This audit highlights the need to review diabetes-related medications and appropriate monitoring strategies in patients on PD, with additional consideration of glycaemic variability related to differing dialysate strengths to optimize outcomes.