Duquennoy Simon, Béchade Clémence, Verger Christian, Ficheux Maxence, Ryckelynck Jean-Philippe, Lobbedez Thierry
Néphrologie, CHU Clemenceau, Caen CEDEX, France.
Registre de dialyse péritonéale de langue Française, Pontoise, France.
Perit Dial Int. 2016 May-Jun;36(3):291-6. doi: 10.3747/pdi.2014.00154. Epub 2015 Dec 3.
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This study was carried out to examine whether or not elderly patients on peritoneal dialysis (PD) had an increased risk of peritonitis. ♦
This was a retrospective cohort study based on data from the French Language Peritoneal Dialysis Registry. We analyzed 8,396 incident patients starting PD between January 2003 and December 2010. The end of the observation period was 31 December 2012. Patients were separated into 2 age groups: up to 75 and over of 75 years old. ♦
Among 8,396 patients starting dialysis there were 3,173 patients older than 75. When using a Cox model, no association was found between age greater than 75 years and increased risk of peritonitis (hazard ratio [HR]: 0.97 [0.88 - 1.07]). Diabetes (HR: 1.14 [1.01 - 1.28] and continuous ambulatory PD (HR: 1.13 [1.04 - 1.23]) were significantly associated with a higher risk of peritoneal infection whereas nurse-assisted PD was associated with a lower risk of peritonitis (HR: 0.85 [0.78 - 0.94]. In the analysis restricted to the 3,840 self-care PD patients, there was no association between age older than 75 years and risk of peritonitis. ♦
The risk of peritonitis is not increased in elderly patients on PD in a country where assisted PD is available.
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本研究旨在探讨接受腹膜透析(PD)的老年患者腹膜炎风险是否增加。♦
这是一项基于法语腹膜透析登记处数据的回顾性队列研究。我们分析了2003年1月至2010年12月开始接受PD的8396例新发病例患者。观察期结束于2012年12月31日。患者被分为两个年龄组:75岁及以下和75岁以上。♦
在8396例开始透析的患者中,有3173例年龄大于75岁。使用Cox模型时,未发现年龄大于75岁与腹膜炎风险增加之间存在关联(风险比[HR]:0.97[0.88 - 1.07])。糖尿病(HR:1.14[1.01 - 1.28])和持续性非卧床腹膜透析(HR:1.13[1.04 - 1.23])与腹膜感染风险较高显著相关,而护士协助的腹膜透析与腹膜炎风险较低相关(HR:0.85[0.78 - 0.94])。在仅限于3840例自我护理腹膜透析患者的分析中,年龄大于75岁与腹膜炎风险之间无关联。♦
在有辅助腹膜透析的国家,接受腹膜透析的老年患者腹膜炎风险并未增加。