| Objective:1. To investigate the relationship between follow-up rate at outpatient clinic and their outcomes in Continuous Ambulatory Peritoneal Dialysis(CAPD) patients. 2. To analyse the factors that influence follow-up rate at outpatient clinic with CAPD. 3. To compare the differences in clinical data between the two groups. Methods:172 patients treated with CAPD for at least 6 months were included in this research. Collecting the general information of patients, including follow-up rate, gender, age, PD duration, causes of disease, outcome, blood pressure, hemoglobin and other biochemistry data. According to median follow-up rate, 172 CAPD patients divided into 2 groups: high follow-up group and low follow-up group. Patients’ nutritional status was evaluated by SGA, serum albumin and so on. Patients’ anxiety/depression status was evaluated by Hamilton Questionair. Patient’s Residual Renal Function(RRF) was assessed by residual Glomerular Filtration Rate( r GFR). Results:1. At the third month of starting CAPD, there were no significant differences in general information and clinical data between two groups.2. At the end-point of the study, patients in low follow-up group had longer PD duration【(20.1±8.4) months vs.(15.9±8.4) months, t=-3.232,P=0.001】, higher level of both systolic blood pressure 【(146.3±23.6)mm Hg vs.(137.9±20.6)mm Hg, t=-2.479, P=0.014 】, and diastolic blood pressure【(90.9±17)mm Hg vs.(84.7±12.9) mm Hg, t=-2.687, P= 0.008】. Compared with high follow-up group patients, there were significantly lower hemoglobin 【(103.8±17.4)g/L vs.(111.5±16.3)g/L, t=2.943, P=0.004】, serum albumin【(29.4±5)g/L vs.(31.1±5.5)g/L, t= 2.144, P=0.033 】, and serum ferrum【(12.9±6.2)umol/L vs.(15.5±7.7)umol/L, t= 2.412, P=0.017】in low follow-up group patients. Furthermore, there were significantly high the incidence of malnutrition( 65.5% vs. 40.7%,Z=-3.227, P=0.001), anxiety( 45.3% vs. 29.1%, Z=-2.202, P=0.028) and depression( 47% vs. 31.8%,Z=-2.171, P=0.03) in low follow-up group patients than high follow-up group.3. Univariate Cox regression analysis showed that the follow-up rate(β=0.981,P=0.042), age(β=1.038,P=0.011), diabetes(β=2.157,P=0.034), serum albumin( β=0.847,P=0.000), serum ferrum(β=0.886,P=0.005), RRF(β=0.691,P=0.003), SGA(β=2.233,P=0.043) were factors affecting survival in CAPD patients. Multivariate Cox regression analysis showed that RRF(RR=0.669,P=0.004), serum albumin(RR=0.884,P=0.001) and age(RR=1.045,P=0.006) were independent factors affecting survival in CAPD patients, and that the follow-up rate at the outpatient clinic was not included in the independent factors for survival. Conclusion:The follow-up rate at the outpatient clinic was unrelated to survival of CAPD patients. But lower follow-up rate at outpatient clinic may associate with aggravating hypoproteinemia, anemia and malnutrition leading to poorer outcomes. Therefore, improving the outpatient clinic follow-up rate is very important to improve outcomes of CAPD patients. |
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