Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China.
Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, 510080, Guangdong, China.
Int Urol Nephrol. 2019 Nov;51(11):2055-2061. doi: 10.1007/s11255-019-02237-8. Epub 2019 Jul 22.
To explore the impact of gender on baseline peritoneal transportation properties and ultrafiltration (UF) ability.
Patients who started peritoneal dialysis (PD) in our PD center were retrospectively analyzed. Peritoneal transportation characteristics and other UF-associated factors were compared between male and female patients. Stepwise linear regression analysis and propensity score (PS) analysis were used to identify the predictors of peritoneal equilibration test (PET) UF.
A total of 1052 patients (424 women and 628 men) were included. Compared with male PD patients, females were older (48.4 ± 15.3 vs 46.0 ± 14.6 years), with less total body water (27.6 ± 2.5 vs 36.9 ± 3.8 L), lower body mass index (21.2 ± 3.4 vs 22.0 ± 2.9 kg/m), lower albumin levels (37.4 ± 5.2 vs 38.0 ± 5.4 g/L), worse renal function [residual glomerular filtration rate: 2.6 (1.2, 3.9) vs 3.2 (1.8, 5.5) mL/min/1.73 m], lower dialysate-to-plasma ratio of creatinine at 4-h PET (D/PCr; 0.68 ± 0.11 vs 0.72 ± 0.12), higher 4-h effluent glucose level/0-h effluent glucose level of PET (D4/D0; 0.41 ± 0.08 vs 0.38 ± 0.08), better UF ability [PET UF: 320 (200, 400) vs 260 (150, 360) mL], and higher Kt/V (2.66 ± 0.60 vs 2.23 ± 0.66) (all P < 0.05) when starting PD. Stepwise linear regression analysis showed that D4/D0, residual urine output, D/PCr, and gender are independently associated with PET UF. By propensity score analysis, female patients still showed significantly more PET UF than male counterparts even with balanced D/PCr, D4/D0, and residual urine.
Among the new PD patients, females showed much higher D4/D0, lower D/PCr, and more PET UF than males, with better PET UF being independent of slower solute transportation.
探讨性别对基础腹膜转运特性和超滤（UF）能力的影响。
回顾性分析在我院 PD 中心开始腹膜透析（PD）的患者。比较了男、女患者的腹膜转运特征和其他 UF 相关因素。采用逐步线性回归分析和倾向评分（PS）分析来确定腹膜平衡试验（PET）UF 的预测因素。
共纳入 1052 例患者（女性 424 例，男性 628 例）。与男性 PD 患者相比，女性年龄更大（48.4±15.3 岁 vs 46.0±14.6 岁），总水量更少（27.6±2.5 升 vs 36.9±3.8 升），体重指数更低（21.2±3.4 千克/米 vs 22.0±2.9 千克/米），白蛋白水平更低（37.4±5.2 克/升 vs 38.0±5.4 克/升），肾功能更差[残余肾小球滤过率：2.6（1.2，3.9）毫升/分钟/1.73 米 vs 3.2（1.8，5.5）毫升/分钟/1.73 米]，4 小时 PET 时透析液与血浆肌酐比（D/PCr）更低（0.68±0.11 比 0.72±0.12），4 小时 PET 时流出液葡萄糖/0 小时流出液葡萄糖比（D4/D0）更高（0.41±0.08 比 0.38±0.08），UF 能力更好[PET UF：320（200，400）毫升比 260（150，360）毫升]，Kt/V 更高（2.66±0.60 比 2.23±0.66）（均 P<0.05）。逐步线性回归分析表明，D4/D0、残余尿量、D/PCr 和性别与 PET UF 独立相关。通过倾向评分分析，即使 D/PCr、D4/D0 和残余尿量平衡，女性患者的 PET UF 仍明显高于男性患者，且更好的 PET UF 与较慢的溶质转运无关。
在新开始 PD 的患者中，女性患者的 D4/D0 更高，D/PCr 更低，UF 更多，且 UF 能力更好，而与溶质转运无关。
