The Clinical Features And Prognostic Analysis Of Patients Without Urine Volume In Hemodialysis And Peritoneal Dialysis

Objective: To compare the clinical features and prognosis of anuria patients in hemodialysis and peritoneal dialysis(PD)and detect some method for the treatment of anuria dialysis patients.Methods: A retrospective cohort study was conduct.Patients who were treated with dialysis(MHD and CAPD)in our center from January 2008 to December 2015 and were anuria(daily urine volume <100ml)were enrolled.The general data,biochemical indicators and the outcome were collected.The clinical characteristics of the two groups were compared between the HD and PD patient.The survival and related risk factors were analysed using the Kaplan-Meier and Cox regression models.The primary end point of study was all-cause mortality.Results:(1)According to the inclusion criteria,234 patients were enrolled.There were 152 cases in CAPD group.There were 82 cases in MHD group with 60(73.2%)male and 22(26.8%)female.The primary diseases were chronic glomerulonephritis in the majority,followed by diabetic nephropathy 、 hypertensive renal damage,etc.The proportion of hypertensive renal damage in CAPD group were higher than in MHD group(χ2=5.66,P=0.017).(2)Clinical data: The dialysis vintage,follow-up time from anuria,BMI,total Kt/V,serum calcium and creatinine levels were higher in group CAPD than that the group of MHD(P < 0.05).The height,serum phosphorus,urea,plasma albumin,serum potassium and blood chlorine were lower than in CAPD group than those in MHD group(P < 0.05).There were no significant differences in age,systolic blood pressure,diastolic blood pressure,body weight,whiteblood cell,hemoglobin,serum iron,i PTH,triglyceride,total cholesterol,low density lipoprotein,high density lipoprotein,blood sugar,blood sodium,combined with carbon dioxide force and the level of high sensitivity C reactive protein between the two groups(P > 0.05)? At the end point,there was a total of 67(28.6%)death cases,including 40 cases in CAPD group.The main causes of death were cardiovascular events in 20(50%)cases,peritonitis in 6(15%)cases,cerebrovascular events in 6(15%)cases,infection in 4(10%)cases,malnutrition in 3(7.5%)cases.Among the 27 deaths in c MHD group,the main cause were cardiovascular events in 18(66.64%),cerebrovascular events 6(22.2%)in cases,infection in 3(11.1%)cases.There was no difference of mortality cause distribution between the two groups.The percentage of peritonitis in CAPD group was significantly higher than that in group MHD(P <0.05).(4)The average survival time of the CAPD group was(23.29 + 23.58)months,while the average survival time of MHD patients was(12.26 + 10.39)months.The overall survival rate in CAPD groups were better than that of MHD group(P < 0.05).(5)The multivariate Cox regression analysis showed that age,serum albumin,blood glucose,high sensitive C reactive protein in urine were risk factors of patients survival in CAPD group(P=0.000).Age of anuria,systolic blood pressure were risk factors in MHD group(P=0.000).Conclusions:Compared with CAPD group,the occurrence of anuria in MHD group is earlier(P=0.023).The survival of CAPD patients was better than the MHD group.The age,serum albumin,blood glucose,high sensitive C reactive protein in urine were risk factors of patients survival in CAPD group(P=0.000).Age of anuria,systolic blood pressure were risk factors in MHD group(P=0.000).