Cao Xue-Ying, Zhou Jian-Hui, Cai Guang-Yan, Tan Ni-Na, Huang Jing, Xie Xiang-Cheng, Tang Li, Chen Xiang-Mei
1. Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing 100853, China.
Int J Med Sci. 2015 May 1;12(4):354-61. doi: 10.7150/ijms.11694. eCollection 2015.
This study aims to investigate basic clinical features of peritoneal dialysis (PD) patients, their prognostic risk factors, and to establish a prognostic model for predicting their one-year mortality. A national multi-center cohort study was performed. A total of 5,405 new PD cases from China Peritoneal Dialysis Registry in 2012 were enrolled in model group. All these patients had complete baseline data and were followed for one year. Demographic and clinical features of these patients were collected. Cox proportional hazards regression model was used to analyze prognostic risk factors and establish prognostic model. A validation group was established using 1,764 new PD cases between January 1, 2013 and July 1, 2013, and to verify accuracy of prognostic model. Results indicated that model group included 4,453 live PD cases and 371 dead cases. Multivariate survival analysis showed that diabetes mellitus (DM), residual glomerular filtration rate (rGFR), , SBP, Kt/V, high PET type and Alb were independently associated with one-year mortality. Model was statistically significant in both within-group verification and outside-group verification. In conclusion, DM, rGFR, SBP, Kt/V, high PET type and Alb were independent risk factors for short-term mortality in PD patients. Prognostic model established in this study accurately predicted risk of short-term death in PD patients.
本研究旨在探讨腹膜透析（PD）患者的基本临床特征、预后危险因素，并建立预测其一年死亡率的预后模型。进行了一项全国多中心队列研究。2012年中国腹膜透析登记处的5405例新PD病例纳入模型组。所有这些患者均有完整的基线数据，并随访一年。收集这些患者的人口统计学和临床特征。采用Cox比例风险回归模型分析预后危险因素并建立预后模型。使用2013年1月1日至2013年7月1日期间的1764例新PD病例建立验证组，以验证预后模型的准确性。结果表明，模型组包括4453例存活的PD病例和371例死亡病例。多因素生存分析显示，糖尿病（DM）、残余肾小球滤过率（rGFR）、收缩压（SBP）、Kt/V、高PET类型和白蛋白与一年死亡率独立相关。该模型在组内验证和组外验证中均具有统计学意义。总之，DM、rGFR、SBP、Kt/V、高PET类型和白蛋白是PD患者短期死亡的独立危险因素。本研究建立的预后模型准确预测了PD患者短期死亡风险。
