a Department of Nephrology , The First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi , China.
Ren Fail. 2019 Nov;41(1):532-539. doi: 10.1080/0886022X.2019.1628062.
Studies have shown that the serum total bilirubin (TBil) is associated with the mortality of the general population and of hemodialysis patients. However, few studies have examined the associations of the direct bilirubin (DBil) and indirect bilirubin (IBil) with the mortality of peritoneal dialysis (PD) patients. This was a retrospective cohort study. Clinical and laboratory data were collected from 740 PD patients. The primary endpoint was 5-year all-cause mortality. Survival analysis was performed using the Kaplan-Meier method with the log-rank test. The mortality hazard ratio was evaluated using Cox regression models. Among the 740 PD patients, the mean age was 49.9 ± 15.0 years, 54.9% were men, and 20.3% had diabetes. During the median follow-up period of 28 months (interquartile range, 14-41 months), 178 patients died. Kaplan-Meier analysis revealed that all-cause mortality was higher in the patients in the higher TBil group than in the lower TBil group (25.6% vs. 18.3%, = .017) and in patients in the higher IBil group than in the lower IBil group (24.3% vs. 19%, = .026). Multivariate analysis showed that compared with the lower TBil group, the 5-year mortality risk was higher in the higher TBil group (HR = 1.69, 95% CI: 1.11-2.56, = .014). Similarly, there was a 56% higher risk of 5-year mortality in the higher IBil group than in the lower IBil group (HR = 1.56, 95% CI: 1.04-2.34, = .032). However, no such associations were observed between the DBil and the mortality risk. The baseline serum TBil and IBil levels were significantly associated with 5-year all-cause mortality among PD patients.
研究表明，血清总胆红素（TBil）与普通人群和血液透析患者的死亡率相关。然而，很少有研究探讨直接胆红素（DBil）和间接胆红素（IBil）与腹膜透析（PD）患者死亡率的关系。本研究为回顾性队列研究。收集了 740 名 PD 患者的临床和实验室数据。主要终点是 5 年全因死亡率。采用 Kaplan-Meier 法和对数秩检验进行生存分析。使用 Cox 回归模型评估死亡率风险比。在 740 名 PD 患者中，平均年龄为 49.9±15.0 岁，54.9%为男性，20.3%患有糖尿病。在中位随访 28 个月（四分位距 14-41 个月）期间，178 名患者死亡。Kaplan-Meier 分析显示，TBil 较高组的全因死亡率高于 TBil 较低组（25.6%比 18.3%， = .017），IBil 较高组的全因死亡率高于 IBil 较低组（24.3%比 19%， = .026）。多变量分析显示，与 TBil 较低组相比，TBil 较高组 5 年死亡率风险更高（HR = 1.69，95%CI：1.11-2.56， = .014）。同样，IBil 较高组的 5 年死亡率风险比 IBil 较低组高 56%（HR = 1.56，95%CI：1.04-2.34， = .032）。然而，DBil 与死亡率风险之间没有这种关联。PD 患者的基线血清 TBil 和 IBil 水平与 5 年全因死亡率显著相关。
