Ahbap Elbis, Sevinç Mustafa
Department of Nephrology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2018 Sep 28;52(3):184-189. doi: 10.14744/SEMB.2018.59219. eCollection 2018.
Residual renal function (RRF) at the initiation of peritoneal dialysis (PD) therapy can be a predictor of survival in stable PD patients. The aim of the present study was to investigate PD patients regarding the effect of baseline RRF on patient and technique survival.
Urine output at the beginning of PD therapy was evaluated retrospectively in 202 PD patients. Patients were divided into two groups: patients with anuria (urine output ≤100 ml/day) and patients without anuria (urine output >100 ml/day).
The number of patients with anuria was 58 in which 38 patients were females. The mean age of the patients was 42.8±14.9 years. The mean follow-up period was 44.2±35 months. Twelve percent of patients with anuria had history of hemodialysis (HD).One hundred forty-four had no anuria (68 females, mean age 43.7±14.5 years, mean follow-up period 39.6±26.1 months, mean urine volume 592±442 ml). Twenty-three patients had received HD therapy before. Sixty-five had anuria in the following 22.5±19.6 months.At the beginning of therapy, systolic and diastolic blood pressures were lower in patients with oliguria than in patients without oliguria (p<0.001), but C-reactive protein (p=0.004) and ferritin (p<0.001) levels were higher. There was no difference between two groups regarding the other parameters (age, follow-up periods, presence of diabetes, ultrafiltration volumes, albumin, hemoglobin, calcium phosphorus product, parathormone, and Kt/V levels) (p>0.05).The peritonitis rate was one episode per 28.2 versus 30 patient-months for the anuric and non-anuric groups, respectively (p>0.05).For Kaplan-Meier survival analysis, the mean technique survival rates at 1 and 3 years were 97% and 86.6% in patients without anuria and 94% and 85.3% in patients with anuria, respectively. The 5-year technique survival rates according to residual volume states were not statistically significant with log-rank test (p>0.05).The 1-, 3-, and 5-year survival rates were 96.9%, 89.6%, and 86.5% in patients without anuria, respectively, whereas they were 87.3%, 77.3%, and 53.7% in patients with anuria, respectively. The 5-year survival rates according to residual volume states were statistically significant (p<0.05).
RRF at the beginning of PD has an important and positive impact on patient survival in PD patients. Peritonitis rates and technique survival were not different for patients with anuria and without anuria.
腹膜透析（PD）治疗开始时的残余肾功能（RRF）可作为稳定期PD患者生存的预测指标。本研究旨在调查基线RRF对PD患者及技术生存的影响。
回顾性评估202例PD治疗开始时的尿量。患者分为两组：无尿患者（尿量≤100 ml/天）和非无尿患者（尿量>100 ml/天）。
无尿患者58例，其中女性38例。患者平均年龄为42.8±14.9岁。平均随访期为44.2±35个月。12%的无尿患者有血液透析（HD）史。144例患者无无尿（68例女性，平均年龄43.7±14.5岁，平均随访期39.6±26.1个月，平均尿量592±442 ml）。23例患者曾接受HD治疗。65例在接下来的22.5±19.6个月出现无尿。治疗开始时，少尿患者的收缩压和舒张压低于非少尿患者（p<0.001），但C反应蛋白（p=0.004）和铁蛋白（p<0.001）水平较高。两组在其他参数（年龄、随访期、糖尿病的存在、超滤量、白蛋白、血红蛋白、钙磷乘积、甲状旁腺激素和Kt/V水平）方面无差异（p>0.05）。无尿组和非无尿组的腹膜炎发生率分别为每28.2例和30患者月1次（p>0.05）。对于Kaplan-Meier生存分析，1年和3年时非无尿患者的平均技术生存率分别为97%和86.6%，无尿患者分别为94%和85.3%。根据残余尿量状态的五年技术生存率经对数秩检验无统计学意义（p>0.05）。非无尿患者的1年、3年和5年生存率分别为96.9%、89.6%和86.5%，而无尿患者分别为87.3%、77.3%和53.7%。根据残余尿量状态的五年生存率有统计学意义（p<0.05）。
PD开始时的RRF对PD患者的生存有重要的积极影响。无尿患者和非无尿患者的腹膜炎发生率和技术生存率无差异。
