Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
Ren Fail. 2012;34(2):149-54. doi: 10.3109/0886022X.2011.646808. Epub 2012 Jan 20.
The mortality rates of end-stage renal disease patients have significantly declined over the past decade. However, there are few reports on the risk factors for mortality in stable peritoneal dialysis (PD) patients who survive for a considerable time.
We reviewed the medical records and identified all adult patients who received PD between April 2001 and March 2009 in our institution. The total cohort was 550 patients. Among these patients, 383 patients were enrolled as stable PD patients.
The cumulative survival of the stable PD patients was 91.6% at 3 years and 78.7% at 5 years. On univariate analysis, old age (≥65 years of age), hypoalbuminemia (<35 g/L), log C-reactive protein (CRP) (≥0.84), phosphorus (<1.13 mmol/L), statin, icodextrin, and the Davies index were associated with mortality for all PD patients. Old age, hypoalbuminemia, log CRP, phosphorus, the residual renal function (RRF) (≤4 mL/min/1.73 m2) at 24 months, renin-angiotensin system blockade, icodextrin, and the Davies index were associated with mortality for the stable PD patients. Multivariate analysis showed that, among the variables, age, log CRP, phosphorus, initial RRF, and the Davies index were associated with mortality for all PD patients. In stable PD patients, age, log CRP, phosphorus, RRF at 24 months, and the Davies index were associated with mortality.
Initial high RRF combined with the RRF preservation, maintenance of proper phosphorus, control of inflammation, and proper management of comorbidities may help to improve the survival of PD patients including stable PD patients.
在过去的十年中，终末期肾病患者的死亡率显著下降。然而，对于存活时间较长的稳定腹膜透析（PD）患者，关于其死亡风险因素的报道很少。
我们回顾了病历，确定了 2001 年 4 月至 2009 年 3 月在我院接受 PD 的所有成年患者。总队列为 550 例患者。在这些患者中，383 例被纳入稳定 PD 患者。
稳定 PD 患者的累积生存率为 3 年时为 91.6%，5 年时为 78.7%。单因素分析显示，高龄（≥65 岁）、低白蛋白血症（<35 g/L）、C 反应蛋白（CRP）对数（≥0.84）、磷（<1.13 mmol/L）、他汀类药物、艾考糊精和 Davies 指数与所有 PD 患者的死亡率相关。高龄、低白蛋白血症、CRP 对数、磷、24 个月时的残余肾功能（RRF）（≤4 mL/min/1.73 m2）、肾素-血管紧张素系统阻滞剂、艾考糊精和 Davies 指数与稳定 PD 患者的死亡率相关。多因素分析显示，在这些变量中，年龄、CRP 对数、磷、初始 RRF 和 Davies 指数与所有 PD 患者的死亡率相关。在稳定 PD 患者中，年龄、CRP 对数、磷、24 个月时的 RRF 和 Davies 指数与死亡率相关。
初始高 RRF 结合 RRF 维持、适当的磷水平、控制炎症和适当的合并症管理，可能有助于提高 PD 患者的生存率，包括稳定 PD 患者。
