Wu Bei, Wang Mei, Gan Liangying, Zhao Huiping
Department of Nephrology, Peking University People's Hospital, Beijing, 100044, China.
Int Urol Nephrol. 2014 Dec;46(12):2403-7. doi: 10.1007/s11255-014-0819-6. Epub 2014 Sep 16.
No study in China has so far investigated the difference in patient survival rates between hemodialysis (HD) and peritoneal dialysis (PD). Therefore, the aim of the present single-center follow-up study was to determine and compare the survival rates associated with HD and PD at a Chinese hospital.
Clinical data were analyzed for all adult patients (age >18 years) with chronic renal failure who dialysis between 2006 and 2010.
The study included 216 patients, 140 of whom underwent PD and 76 of whom underwent HD. Compared to patients in the HD group, patients in the PD group were older (61 ± 14 vs. 55 ± 14 years, P = 0.004) and had higher baseline blood uric acid levels (452 ± 136 vs. 388 ± 150 μmol/L, P = 0.002) and lower baseline iPTH (224 ± 260 vs. 305 ± 267 pg/ml, P = 0.036). Moreover, a higher number of PD patients had diabetes (40 vs. 27.6 %, P = 0.056). The average follow-up time was 25 months in the PD group and 36 months in the HD group. The 1-, 2- and 3-year survival rates were 98.7, 93.2, and 85.5 %, respectively, in the HD group and 90.9, 81.5, and 73.8 %, respectively, in the PD group. In the first 3 years, HD was associated with better survival compared to the PD group. However, when adjusted for age, diabetes and BMI, there was no significant difference between the PD and HD group.
The mode of dialysis itself has no effect on the survival rate of ESRD patients on dialysis.
目前中国尚无研究调查血液透析（HD）和腹膜透析（PD）患者生存率的差异。因此，本单中心随访研究的目的是确定并比较中国一家医院HD和PD的生存率。
分析了2006年至2010年间进行透析的所有成年慢性肾衰竭患者（年龄>18岁）的临床资料。
该研究纳入216例患者，其中140例行PD，76例行HD。与HD组患者相比，PD组患者年龄更大（61±14岁对55±14岁，P=0.004），基线血尿酸水平更高（452±136对388±150μmol/L，P=0.002），基线iPTH更低（224±260对305±267pg/ml，P=0.036）。此外，PD患者中糖尿病患者数量更多（40%对27.6%，P=0.056）。PD组平均随访时间为25个月，HD组为36个月。HD组1年、2年和3年生存率分别为98.7%、93.2%和85.5%，PD组分别为90.9%、81.5%和73.8%。在最初3年，HD组生存率优于PD组。然而，在对年龄、糖尿病和BMI进行校正后，PD组和HD组之间无显著差异。
透析方式本身对接受透析的终末期肾病患者的生存率没有影响。
