Kee Youn Kyung, Park Jung Tak, Yoon Chang-Yun, Kim Hyoungnae, Park Seohyun, Yun Hae Ryong, Jung Su-Young, Jhee Jong Hyun, Oh Hyung Jung, Han Seung Hyeok, Yoo Tae-Hyun, Kang Shin-Wook
Department of Medicine, Yonsei University Graduate School of Medicine, Brain Korea 21 PLUS, Yonsei University, Seoul, Korea.
Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Brain Korea 21 PLUS, Yonsei University, Seoul, Korea.
Perit Dial Int. 2017 Sep-Oct;37(5):535-541. doi: 10.3747/pdi.2016.00227. Epub 2017 May 25.
Maintaining peritoneal dialysis (PD) for a long time is problematic owing to a number of factors. This study aimed to clarify the characteristics and examine the clinical outcomes of patients who received PD as a long-term dialysis modality.
All end-stage renal disease (ESRD) patients who initiated PD at Yonsei University Health System between 1987 and 2000 were screened. Patients who maintained PD for over 15 years were classified as the long-term PD group and those who were treated with PD for less than 5 years were included in the short-term PD group. Demographic and biochemical data and clinical outcomes were compared between the groups. Independent factors associated with long-term PD maintenance were ascertained using multivariate logistic regression analysis.
Among 1,116 study patients, 87 (7.8%) were included in the long-term group and 293 (26.3%) were included in the short-term group. In the long-term group, the mean patient age at PD initiation was 39.6 ± 11.5 years, 35 patients (40.2%) were male, and the mean PD duration was 205.3 ± 32.7 months. Patients were younger, body weight was lower, the proportion of patients with diabetes or cardiovascular diseases was lower, and the proportion of low to low-average transporters was higher in the long-term group than in the short-term group ( < 0.001). Multiple logistic regression analysis revealed that age, body mass index (BMI), serum creatinine, type of PD solution, and diabetes were significant independent factors associated with long-term PD maintenance.
Peritoneal dialysis can be considered as a long-term renal replacement therapy option, especially in non-diabetic, not overweight, and young ESRD patients.
由于多种因素，长期维持腹膜透析（PD）存在问题。本研究旨在阐明接受PD作为长期透析方式的患者的特征并检查其临床结局。
筛选了1987年至2000年在延世大学健康系统开始进行PD的所有终末期肾病（ESRD）患者。维持PD超过15年的患者被分类为长期PD组，接受PD治疗少于5年的患者被纳入短期PD组。比较两组之间的人口统计学和生化数据以及临床结局。使用多变量逻辑回归分析确定与长期PD维持相关的独立因素。
在1116名研究患者中，87名（7.8%）被纳入长期组，293名（26.3%）被纳入短期组。在长期组中，开始PD时患者的平均年龄为39.6±11.5岁，35名患者（40.2%）为男性，平均PD持续时间为205.3±32.7个月。长期组患者比短期组患者更年轻、体重更低、糖尿病或心血管疾病患者比例更低，低至低平均转运体患者比例更高（<0.001）。多变量逻辑回归分析显示，年龄、体重指数（BMI）、血清肌酐、PD溶液类型和糖尿病是与长期PD维持相关的重要独立因素。
腹膜透析可被视为一种长期肾脏替代治疗选择，尤其是对于非糖尿病、不过重且年轻的ESRD患者。
