Tian Jun-Ping, Wang Hong, Du Feng-He, Wang Tao
Department of Cardiology, Beijing Tian Tan Hospital, Capital Medical University, No. 6, Tian Tan Xi Li, Dongcheng District, Beijing, 100050, People's Republic of China.
Department of Endocrinology, Aerospace Center Hospital, Beijing, People's Republic of China.
Int Urol Nephrol. 2016 Sep;48(9):1547-54. doi: 10.1007/s11255-016-1371-3. Epub 2016 Jul 20.
The mortality rate of peritoneal dialysis (PD) patients is still high, and the predicting factors for PD patient mortality remain to be determined. This study aimed to explore the relationship between the standard deviation (SD) of extracellular water/intracellular water (E/I) and all-cause mortality and technique failure in continuous ambulatory PD (CAPD) patients.
All 152 patients came from the PD Center between January 1st 2006 and December 31st 2007. Clinical data and at least five-visit E/I ratio defined by bioelectrical impedance analysis were collected. The patients were followed up till December 31st 2010. The primary outcomes were death from any cause and technique failure. Kaplan-Meier analysis and Cox proportional hazards models were used to identify risk factors for mortality and technique failure in CAPD patients.
All patients were followed up for 59.6 ± 23.0 months. The patients were divided into two groups according to their SD of E/I values: lower SD of E/I group (≤0.126) and higher SD of E/I group (>0.126). The patients with higher SD of E/I showed a higher all-cause mortality (log-rank χ (2) = 10.719, P = 0.001) and technique failure (log-rank χ (2) = 9.724, P = 0.002) than those with lower SD of E/I. Cox regression analysis found that SD of E/I independently predicted all-cause mortality (HR 3.551, 95 % CI 1.442-8.746, P = 0.006) and technique failure (HR 2.487, 95 % CI 1.093-5.659, P = 0.030) in CAPD patients after adjustment for confounders except when sensitive C-reactive protein was added into the model.
The SD of E/I was a strong independent predictor of all-cause mortality and technique failure in CAPD patients.
腹膜透析（PD）患者的死亡率仍然很高，PD患者死亡的预测因素尚待确定。本研究旨在探讨持续性非卧床腹膜透析（CAPD）患者细胞外液/细胞内液（E/I）标准差（SD）与全因死亡率及技术失败之间的关系。
所有152例患者均来自2006年1月1日至2007年12月31日期间的腹膜透析中心。收集临床资料以及通过生物电阻抗分析定义的至少五次就诊时的E/I比值。对患者随访至2010年12月31日。主要结局为任何原因导致的死亡和技术失败。采用Kaplan-Meier分析和Cox比例风险模型来确定CAPD患者死亡和技术失败的危险因素。
所有患者随访时间为59.6±23.0个月。根据E/I值的SD将患者分为两组：E/I低SD组（≤0.126）和E/I高SD组（>0.126）。E/I高SD组患者的全因死亡率（对数秩检验χ(2)=10.719，P=0.001）和技术失败率（对数秩检验χ(2)=9.724，P=0.002）均高于E/I低SD组患者。Cox回归分析发现，在调整混杂因素后，除将敏感C反应蛋白纳入模型外，E/I的SD独立预测CAPD患者的全因死亡率（HR 3.551，95%CI 1.442 - 8.746，P=0.006）和技术失败率（HR 2.487，95%CI 1.093 - 5.659，P=0.030）。
E/I的SD是CAPD患者全因死亡率和技术失败的强有力独立预测因素。
