Huang Naya, Chen Jiehui, Fan Li, Zhou Qian, Xu Qingdong, Xu Ricong, Xiong Liping, Yu Xueqing, Mao Haiping
Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health of China, Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, Guangdong, China.
Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health of China, Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, Guangdong, China; Department of Nephrology, The Sixth People's Hospital of Shenzhen, Shenzhen, Guangdong, China.
PLoS One. 2014 Oct 16;9(10):e110445. doi: 10.1371/journal.pone.0110445. eCollection 2014.
Continuous ambulatory peritoneal dialysis (CAPD) patients with diabetes are at increased risk of mortality and high peritoneal transporters appear to contribute to poor survival. However, little is known about the combined impacts of high peritoneal transporters and diabetes on mortality.
This was a prospective observational cohort study. 776 incident CAPD patients were enrolled. Unadjusted and adjusted Cox proportional regression models were used to evaluate the association and interaction of peritoneal transport and diabetic status with mortality.
In the entire cohort, high peritoneal transport status was associated with an increased risk of all-cause mortality in unadjusted model [hazard ratio (HR) 2.35, 95% confidence interval (CI) 1.30 to 4.25, P = 0.01], but this association was not significant in multivariable model. There was an interaction between peritoneal membrane transport status and diabetes (P = 0.028). Subgroup analyses showed that compared to low and low average transporters, high transporters was associated with a higher risk of all-cause mortality (adjusted HR 1.78, 95% CI 1.07 to 4.70, P = 0.04) in CAPD patients without diabetes, but not in those with diabetes (adjusted HR 0.79, 95%CI 0.33 to 1.89, P = 0.59). Results were similar when transport status was assessed as a continuous variable.
The association between high peritoneal transport and all-cause mortality was likely to vary with diabetes status. High peritoneal transport was associated with an elevated risk of death among CAPD patients without diabetes, but not in those with diabetes.
糖尿病持续非卧床腹膜透析（CAPD）患者的死亡风险增加，高腹膜转运者似乎导致生存率低下。然而，关于高腹膜转运和糖尿病对死亡率的综合影响知之甚少。
这是一项前瞻性观察队列研究。纳入776例新发CAPD患者。采用未调整和调整的Cox比例回归模型评估腹膜转运和糖尿病状态与死亡率的关联及相互作用。
在整个队列中，在未调整模型中，高腹膜转运状态与全因死亡率风险增加相关[风险比（HR）2.35，95%置信区间（CI）1.30至4.25，P = 0.01]，但在多变量模型中该关联不显著。腹膜转运状态和糖尿病之间存在相互作用（P = 0.028）。亚组分析显示，与低和低平均转运者相比，在无糖尿病的CAPD患者中，高转运者与全因死亡率风险较高相关（调整后HR 1.78，95%CI 1.07至4.70，P = 0.04），但在糖尿病患者中并非如此（调整后HR 0.79，95%CI 0.33至1.89，P = 0.59）。当将转运状态评估为连续变量时，结果相似。
高腹膜转运与全因死亡率之间的关联可能因糖尿病状态而异。高腹膜转运与无糖尿病的CAPD患者死亡风险升高相关，但与糖尿病患者无关。
