Clinical Analysis Of 158 Patients With End-stage Renal Disease Undergoing Peritoneal Dialysis

Objective: To study the clinical features,biochemical parameters and related complications of patients with end-stage renal disease undergoing peritoneal dialysis in our center in order to more effectively manage peritoneal dialysis patients systematically.Methods: A total of 158 patients with end-stage renal disease undergoing peritoneal dialysis in the First Affiliated Hospital of Nanhua University from January 2016 to October 2017 were collected.The basic data and changes in serum markers at different time points after peritoneal dialysis treatment were collected.Related complications,readmission causes and outcomes were counted and analyzed.Results: The catheterization of 158 patients with end-stage renal disease undergoing peritoneal dialysis age ranged from 30 to 50 years old,accounting for 46.8%.The mean catheterization age was 44.46±12.70 years.The ratio of male to female is 1.43:1.The way of catheterization were surgical incision;The primary disease was chronic glomerulonephritis,which is 92 cases accounted for 58.2%,followed by diabetic nephropathy which is 11 cases accounted for 7%.Most patients had urinary protein positive(91.1%),of which urinary protein 2+ was 73 patients(46.2%)and urinary protein 3+ was 38 patients(24.1%).Cardiac echocardiography showed that 17 patients(10.6%)had an ejection fraction of less than 55%,34 patients(21.5%)with left ventricular enlargement,54 patients(34.2%)with left atrium enlargement,123 patients(77.9%)with right ventricular enlargement,8 patients(5%)with right atrium enlargement.143 patients(90.5%)using daytime ambulatory peritoneal dialysis(DAPD),15 patients(9.5%)using continuous ambulatory peritoneal dialysis(CAPD);There were 153 patients(96.8%)who used 1.5% GS peritoneal dialysate alone,and 5 patients(3.2%)who used both 1.5% GS and 2.5% GS peritoneal dialysate.The peritoneal equilibration test showed 27 cases(17.1%)of low transport,59 cases(37.3%)of low average transport,23 cases(14.6%)of high average transport,7 cases(4.4%)of high transport,and 42 cases of loss.After 1 month of peritoneal dialysis,total protein,transferrin,hematocrit,hemoglobin,blood calcium,bicarbonate ions increased,blood potassium,blood phosphorus,blood urea nitrogen,blood creatinine,parathyroid hormone decreased,the difference was statistically significant(P <0.05).There were no significant differences in albumin,ferritin(P>0.05).After 6 month of peritoneal dialysis,total protein,transferrin,hematocrit,hemoglobin,blood calcium,bicarbonate ions increased,blood potassium,serum phosphorus,blood urea nitrogen,residual kidney KT/V,total KT/V decreased,the difference was statistically significant(P <0.05).There was no significant difference in blood creatinine,parathyroid hormone,albumin,ferritin(P>0.05).Peritoneal dialysis-related peritonitis in 158 patients with PD was found in 25 cases(15.8%).The peritoneal dialysis bacterial culture examination results showed that there were 7 cases(28%)of Gram-positive bacteria(2 cases of Streptococcus pyogenes,1 case of Streptococcus agalactiae,1 case of Staphylococcus wurtzii,2 cases of Staphylococcus epidermidis,1 case of golden yellow Staphylococcus),7 cases(28%)of Gram-negative bacteria(Escherichia coli in 5 cases,Escherichia cloacae in 2 cases),and 11 cases(44%)without pathogenic bacteria.There were 65 patients(41.1%)of 158 patients with PD who were rehospitalized for infection or heart failure,including 52 patients(80%)were rehospitalized because of infection(including 25 cases of peritoneal dialysis-related peritonitis,18 cases of respiratory infection,6 cases of urinary tract infection,2 cases of peritoneal dialysis catheter infection,1 case of peritoneal dialysis tube tunnel infection).9 patients(13.8%)were rehospitalized because of cardiac failure.4 patients(6.2%)were rehospitalized because of infection and cardiac failure.158 patients with PD were switched to hemodialysis in 10 cases(6.3%),mainly due to PD-related infections(including 7 cases of peritonitis,2 cases of ductal infection,1 case of tunnel infection).5 patients(3.2%)were switched to kidney transplants.1 patient(0.6%)were died due to a cardiovascular accident.Conclusion:1.After 1 month of peritoneal dialysis,total protein,transferrin,hematocrit,hemoglobin,blood calcium,bicarbonate ions increased,blood potassium,blood phosphorus,blood urea nitrogen,blood creatinine,parathyroid hormone decreased,the difference was statistically significant(P <0.05).There were no significant differences in albumin,ferritin(P>0.05).2.After 6 month of peritoneal dialysis,total protein,transferrin,hematocrit,hemoglobin,blood calcium,bicarbonate ions increased,blood potassium,serum phosphorus,blood urea nitrogen,residual kidney KT/V,total KT/V decreased,the difference was statistically significant(P <0.05).There was no significant difference in blood creatinine,parathyroid hormone,albumin,ferritin(P>0.05).3.In the peritoneal dialysis center,158 cases of end-stage renal disease undergoing peritoneal dialysis patients were rehospitalized mainly for infection,PD-associated peritonitis was the most common,followed by pulmonary infection.