Burton P R, Walls J
Lancet. 1987 May 16;1(8542):1115-9. doi: 10.1016/s0140-6736(87)91674-6.
To investigate the controversy surrounding the life-expectancy of patients on continuous ambulatory peritoneal dialysis (CAPD) compared with that of patients on haemodialysis or transplantation mortality data from 389 patients accepted for renal replacement therapy in Leicester between July, 1974, and July, 1985, were retrospectively analysed with respect to a wide range of pre-treatment variables (6 scales and 115 binary variables), by a method (Cox's) that adjusts for the distorting influence of selection bias. 9 independent variables were identified as having a significant influence on survival. Adverse factors were age, amyloidosis, ischaemic heart disease, convulsions, and acute presentation. Beneficial variables were male sex, parenthood, pyelonephritis, and residence in Leicestershire. By correcting for the influence of these variables and using time-dependent treatment co-variates, the bias adjusted estimates of the relative risk of death were 1 for patients on CAPD, 1.30 for those on haemodialysis, and 1.09 for patients who received transplants. These risks do not differ significantly from one another and suggest that CAPD is at least as effective as haemodialysis or transplantation at preserving life.
为研究持续非卧床腹膜透析（CAPD）患者与血液透析或肾移植患者预期寿命方面的争议，我们对1974年7月至1985年7月在莱斯特接受肾脏替代治疗的389例患者的死亡率数据进行了回顾性分析，这些数据涉及广泛的治疗前变量（6个量表和115个二元变量），采用一种（考克斯方法）可调整选择偏倚扭曲影响的方法。确定了9个对生存有显著影响的独立变量。不利因素为年龄、淀粉样变性、缺血性心脏病、惊厥和急性发病。有利变量为男性、为人父母、肾盂肾炎以及居住在莱斯特郡。通过校正这些变量的影响并使用随时间变化的治疗协变量，CAPD患者死亡相对风险的偏倚调整估计值为1，血液透析患者为1.30，接受移植患者为1.09。这些风险彼此之间无显著差异，表明在维持生命方面，CAPD至少与血液透析或肾移植一样有效。
