Kitterer Daniel, Segerer Stephan, Braun Niko, Alscher M Dominik, Latus Joerg
Department of Internal Medicine, Division of General Medicine and Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany.
Division of Nephrology, University Hospital, Zurich, Switzerland.
Kidney Blood Press Res. 2017;42(2):276-283. doi: 10.1159/000477449. Epub 2017 May 25.
BACKGROUND/AIMS: Gender-specific differences between patients on renal replacement therapy have so far rarely been investigated. In the present study we aimed to describe gender-specific differences in a large cohort of peritoneal dialysis (PD) patients.
Clinical information for all patients who started PD at our center has been collected since the start of the PD-program in 1979. We used Cox regression to examine associations between technique failure and gender. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs).
A total of 745 patients (315 women and 430 men with a median age of 57 years; IQR 43-67) started PD between 1979 and 2015 in our center. Women were significantly younger at PD start 54 (40-65) years vs. 58 (47-68) years, p<0.001. Within the last almost 15 years, more man than women started PD, but technical survival rates were significantly better in female compared to men (HR=0.662, CI 95% (0.496-0.885) P=0.005). Cardiovascular events were the main cause of death over the study period in both sexes, but decreased over time. Additionally, death due to PD-associated peritonitis decreased significantly over the three decades in both sexes.
Our data suggest that technical survival rates were significantly better in female compared to men over three decades and death due to cardiovascular events and PD-associated peritonitis decreased significantly over the three decades in both sexes.
背景/目的：迄今为止，很少有人研究接受肾脏替代治疗的患者的性别差异。在本研究中，我们旨在描述一大群腹膜透析（PD）患者的性别差异。
自1979年PD项目启动以来，我们收集了在本中心开始接受PD治疗的所有患者的临床信息。我们使用Cox回归分析技术失败与性别的关联。我们估计了风险比（HR）及其95%置信区间（CI）。
1979年至2015年间，共有745例患者（315名女性和430名男性，中位年龄57岁；四分位间距43 - 67岁）在本中心开始接受PD治疗。女性开始PD治疗时的年龄显著更小，分别为54（40 - 65）岁和58（47 - 68）岁，p<0.001。在过去近15年中，开始接受PD治疗的男性多于女性，但女性的技术生存率显著高于男性（HR = 0.662，95%CI（0.496 - 0.885），P = 0.005）。在研究期间，心血管事件是两性死亡的主要原因，但随着时间推移有所下降。此外，在这三十年中，两性因PD相关腹膜炎导致的死亡均显著下降。
我们的数据表明，在三十年的时间里，女性的技术生存率显著高于男性，并且在这三十年中，两性因心血管事件和PD相关腹膜炎导致的死亡均显著下降。
