| Objective:To study the clinical indexes,complications and prognosis of continuous ambulatory peritoneal dialysis patients with different peritoneal transport characteristics in our hospital and to explore the factors influencing baseline peritoneal transport characteristics,survival rate and technical survival rate.Methods:A total of 216 patients with continuous ambulatory peritoneal dialysis for at least3 months from January 2012 to August 2017 in our hospital were enrolled in this study.According to the peritoneal equilibration test results in the first 6 months,they were divided into 2 groups: a low average and low peritoneal transport group(Group A),a high average and high peritoneal transport group(Group B).The clinical data of the patients were retrospectively analyzed,including general indicators: gender,age,primary disease,mean arterial pressure,body mass index,24-hour urine output,etc.Peritoneal dialysis(baseline),biochemical indicators of 6 months,1 year,2 years,and3 years of dialysis,peritoneal dialysis related indicators,cardiovascular complications,diabetic retinopathy,peritoneal dialysis peritonitis and the outcome of the patients.To explore the influencing factors of baseline peritoneal transport characters and survival rates,technical survival factors.Results:1.Baseline values: The dialysis time,prealbumin,and ultrafiltration volume of patients in group A were higher than those in group B(p<0.05).The ratio of D / P,peritoneal creatinine clearance rate,age,troponin,hypersensitive C-reactive protein,Brain natriuretic peptide and diabetic retinopathy in group B was higher than that in group A(p<0.05).After 6 months,1 year,2 years and 3 years follow-up,the albumin,urea nitrogen and parathyroid hormone in group A were significantly higher than those in group B(p<0.05),and were followed up for 1 year,2 years and 3 years,The serum creatinine in group A and serum phosphorus were significantly higher than those in group B(p<0.05).The ultrafiltration volume of group A was significantly higher than that of group B after 6 months,2 years and 3 years of follow-up Group,the difference was statistically significant(p<0.05);6 months and 1 year follow-up,the blood glucose of group B patients were significantly higher than the A group,the difference was statistically significant(p<0.05).2.D / Pcr was positively correlated with troponin and hypersensitive C-reactive protein(r = 0.179 and 0.149,p all <0.05).The dichotomous multivariate logistic regression showed that the low prealbumin(OR=0.995,p <0.05),high mean arterial pressure(OR = 1.031,p <0.05),high blood glucose(OR=1.230,p<0.05)and diabetic retinopathy(OR = 3.025,p<0.05)are risk factors for high peritoneal transit in patients.3.The survival rate of group B patients was lower than that of group A(p<0.05),and the technical survival rate was no significant difference between the two groups.Cardiovascular disease and peritoneal hyper-transport are independent risk factors for the survival rate of peritoneal dialysis patients.Low left ventricular ejection fraction and high left ventricular posterior wall thickness are independent risk factors of technical survival rate in peritoneal dialysis patients.Conclusions:1.High mean arterial pressure,low prealbumin,high blood glucose,diabetic retinopathy are the risk factors of peritoneal dialysis patients with high baseline peritoneal transport.2.The survival rate of patients in high average and high peritoneal transport group(Group B)is lower than that in low average and low peritoneal transport group(Group A),there is no significant difference in technical survival rate between the two groups.Cardiovascular diseases and high peritoneal transport are independent risk factors of death in continuous ambulatory peritoneal dialysis patients.Low left ventricular ejection fraction and high left ventricular posterior wall thickness are the independent risk factors of patients’ technical survival rate. |
PDF Full Text Request