Adv Perit Dial. 1992;8:88-92.
The adequacy of peritoneal dialysis should be defined by clinical outcomes. Studies using multivariate techniques to evaluate the effect of demographic and clinical risk factors on these clinical outcomes showed worse patient survival for age > 60 years, diabetes mellitus, history of cardiovascular disease, black race and prior ESRD therapy. The single study reporting a multivariate analysis of urea kinetics and these baseline prognostic factors on clinical outcome showed serum albumin to be the most powerful predictor of survival. A multicentre study (10 Canadian and 4 US Centres) has enrolled 374 consecutive new peritoneal dialysis patients. The target enrollment is 600 patients. Among these 374 patients are 217 males (58%), 71 patients age > 70 (19%), 106 with diabetic renal disease (28%), 95 with a history of cardiovascular disease (25%) and 60 with serum albumin values < 30 Gm/L (16%). There are 307 white patients (82%) and 26 black patients (7%). The 9 month probabilities were: for patient survival, 96%; for technique survival, 93%; peritonitis-free survival, 68%; exit site infection-free survival, 71%. Final statistical analysis will use multivariate techniques to evaluate the relationships among baseline prognostic factors, nutritional status and clinical outcomes.
腹膜透析的充分性应由临床结果来定义。运用多变量技术评估人口统计学和临床风险因素对这些临床结果影响的研究表明，年龄>60岁、患有糖尿病、有心血管疾病史、黑人种族以及既往接受过终末期肾病治疗的患者生存率较低。唯一一项报告了尿素动力学与这些基线预后因素对临床结果进行多变量分析的研究表明，血清白蛋白是生存的最有力预测指标。一项多中心研究（10个加拿大中心和4个美国中心）已连续纳入374例新的腹膜透析患者。目标入组人数为600例患者。在这374例患者中，男性217例（58%），70岁以上患者71例（19%），糖尿病肾病患者106例（28%），有心血管疾病史患者95例（25%），血清白蛋白值<30 g/L的患者60例（16%）。白人患者307例（82%），黑人患者26例（7%）。9个月时的概率分别为：患者生存率96%；技术生存率93%；无腹膜炎生存率68%；无出口部位感染生存率71%。最终的统计分析将使用多变量技术来评估基线预后因素、营养状况和临床结果之间的关系。
