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慢性腹膜透析患者发生严重腹膜硬化的危险因素。

Risk factors of severe peritoneal sclerosis in chronic peritoneal dialysis patients.

作者信息

Alatab Sudabeh, Najafi Iraj, Pourmand Gholamreza, Hosseini Mostafa, Shekarchian Soroosh

机构信息

a Urology Department, Urology Research Center , Sina Hospital, Tehran University of Medical Sciences , Tehran , Iran.

b Department of Nephrology, Nephrology Research Center , Shariati Hospital, Tehran University of Medical Sciences , Tehran , Iran.

出版信息

Ren Fail. 2017 Nov;39(1):32-39. doi: 10.1080/0886022X.2016.1244075. Epub 2016 Oct 24.

Abstract

Peritoneal dialysis (PD) offers the healthiest way for starting renal replacement therapy (RRT) in End Stage Renal Disease patients, however exposes long-term PD patients to a dangerous complication named encapsulating peritoneal sclerosis (EPS). In this study, we searched for possible risk factors of EPS. Data were collected from two PD centers covering period 1995-2012 and comprised 464 patients. Control group defined as PD patients stayed on PD >42 month (n = 122), and case group was 12 confirmed EPS patients. Associations were analyzed using linear regression analysis. Prevalence and incidence of EPS were 2.59% and 8.9% with an incidence of 0.7% patient-years, respectively. The age at start of PD in EPS patients (32.75 ± 10.8 year) was significantly lower compared with control group (49.61 ± 16.18 year, p = .0001). The mean duration of PD in EPS and control group were 2494.4 ± 940.9 and 1890.2 ± 598.8 days (p = .002). Control group had 145 episodes of peritonitis during total duration of 7686 patient months (peritonitis rate of 1/53). This was 1/26 with a total 38 episodes of peritonitis during the total duration of 997 patient months (p = .01) for EPS group. In regression analysis, PD duration, age at PD start and duration of Ultrafiltration failure (UFF) were associated with EPS. Longer time being on PD, younger age, and higher UFF duration were the risk factors for EPS development.

摘要

腹膜透析(PD)为终末期肾病患者开始肾脏替代治疗(RRT)提供了最健康的方式,然而长期接受PD治疗的患者会面临一种名为包裹性腹膜硬化症(EPS)的危险并发症。在本研究中,我们探寻了EPS可能的风险因素。数据收集自两个PD中心,涵盖1995年至2012年期间,共464例患者。对照组定义为接受PD治疗超过42个月的PD患者(n = 122),病例组为12例确诊的EPS患者。采用线性回归分析来分析相关性。EPS的患病率和发病率分别为2.59%和8.9%,患者年发病率为0.7%。EPS患者开始PD治疗时的年龄(32.75 ± 10.8岁)显著低于对照组(49.61 ± 第十六章 16.18岁,p = 0.0001)。EPS组和对照组的平均PD治疗时长分别为2494.4 ± 940.9天和1890.2 ± 598.8天(p = 0.002)。对照组在7686个患者月的总时长内发生了145次腹膜炎(腹膜炎发生率为1/53)。EPS组在997个患者月的总时长内共发生38次腹膜炎,发生率为1/26(p = 0.01)。在回归分析中,PD治疗时长、开始PD治疗时的年龄以及超滤失败(UFF)时长与EPS相关。PD治疗时间越长、年龄越小以及UFF时长越高是EPS发生的风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e566/6014288/f6729e79e7c8/IRNF_A_1244075_F0001_C.jpg

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