| Objective:To investigate the effects of interim hemodialysis(HD)on the survival and prognosis of patients with maintenance peritoneal dialysis(PD)before and after propensity score matching(PSM),and its related factors.Methods:A retrospective analysis was conducted on the clinical data of the patients that received PD catheter implantation and maintenance PD during 1 January 2010-31 December 2014,and the patients were followed up regularly for at least 3 months.The data comes from the dialysis registration system of Zhejiang Provincial Dialysis Quality Control Center.According to whether the patients had received HD or not before the PD,they were divided into 2 groups:non-HD group and interim HD group(HD time<3 months).The two groups were compared in terms of survival rate and factors influencing survival by Kaplan-Meier curve and COX regression analysis.Results:908 patients with PD were included,with 732 in the non-HD group and 176 in the interim HD group.The 1/2/3/4-year survival rate of the patients in the non-HD group reached 96.2%,91.4%,88%and 85%respectively;that in the interim HD group was 92.8%,88.8%,78.2%and 78.2%respectively,suggesting a statistically significant difference(P<0.05);there was no significant difference in technical survival rate between the two groups.COX regression analysis suggested that the patients' history of interim HD,age,serum albumin level,and comorbidity index grade were independent risk factors influencing survival.However,there was no significant difference in survival rate between the two groups after PSM,The 1/2/3/4-year survival rate of the patients in the non-HD group reached 96%,89%,84%,84%,respectively;that in the interim HD group was 93%,90%,81%,81%,P>0.05,whereas it was found that interim HD was not an independent risk factor influencing prognosis,while age,serum albumin,comorbidity index and urine volume during dialysis were the independent risk factors.Conclusions:The long-term survival rate of the patients that had received interim HD was obviously lower than that of the patients that hadn't ever received interim HD,but there was no significant difference between the two groups after PSM.In particular,age,serum albumin,comorbidity index and urine volume during dialysis were independent risk factors that greatly influenced prognosis,so a proper PD way and time should be emphatically selected,an individualized PD program should be developed for different patients,and meanwhile importance should be attached to planning,as well as propaganda and education for patients,before PD. |
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