Department of Nephrology, Peking University Third Hospital, Beijing, China.
Department of Nephrology, The Forth Hospital of Daqing, Daqing, China.
Ren Fail. 2020 Nov;42(1):684-692. doi: 10.1080/0886022X.2020.1792316.
It is unclear whether patients with end-stage renal disease (ESRD) and nephrotic syndrome (NS) can be treated with peritoneal dialysis (PD).
To investigate the outcomes of PD treatment in ESRD patients with or without NS.
In this retrospective cohort study, all incident patients with ESRD and NS who started PD from 1 February 2006 to 31 December 2017, were matched with patients without NS using propensity scores based on age, sex, diabetes mellitus status, and serum albumin.
Fifty-three patients in the NS PD group and 53 matched controls were included. The median survival of the NS PD group was comparable to that of the non-NS PD group. An interaction effect was observed between survival time and baseline NS status. Thus, patients' outcomes within and after 1.5 years were analyzed separately. Both mortality (log-rank test, = .235) and technique failure (log-rank test, = .543) rates within 1.5 years in patients with NS were comparable to those of the non-NS group. After 1.5 years, however, the NS status at baseline was associated with lower all-cause mortality (= .020) and lower technique failure (= .008) rates in PD patients compared with the non-NS group. The multivariable Cox regression analysis showed that compared with the patients in the non-NS PD group, PD patients with NS had both significantly lower all-cause mortality and lower technique failure rate after adjusting for other factors.
Our study indicates that PD may be considered as a long-term renal replacement therapy for patients with ESRD and baseline NS.
目前尚不清楚终末期肾病（ESRD）合并肾病综合征（NS）的患者是否可以接受腹膜透析（PD）治疗。
研究 ESRD 合并 NS 患者接受 PD 治疗的结局。
本回顾性队列研究纳入了 2006 年 2 月 1 日至 2017 年 12 月 31 日期间开始 PD 的所有 ESRD 合并 NS 患者，并基于年龄、性别、糖尿病状态和血清白蛋白，采用倾向评分匹配无 NS 的患者。
纳入了 53 例 NS PD 组和 53 例匹配对照组患者。NS PD 组的中位生存时间与非 NS PD 组相当。生存时间和基线 NS 状态之间存在交互作用，因此，分别分析了患者在 1.5 年内和 1.5 年后的结局。1.5 年内，NS 组的死亡率（对数秩检验，= 0.235）和技术失败率（对数秩检验，= 0.543）与非 NS 组相当。然而，1.5 年后，与非 NS 组相比，基线时存在 NS 的患者的全因死亡率（= 0.020）和技术失败率（= 0.008）均较低。多变量 Cox 回归分析表明，与非 NS PD 组患者相比，调整其他因素后，NS PD 患者的全因死亡率和技术失败率均显著降低。
本研究表明，对于 ESRD 合并基线 NS 的患者，PD 可能是一种长期肾脏替代治疗方法。
