Department of Nephrology, Graduate School of Medicine, Nippon Medical School.
J Nippon Med Sch. 2022 Mar 11;89(1):72-80. doi: 10.1272/jnms.JNMS.2022_89-201. Epub 2021 Apr 19.
The number of patients on peritoneal dialysis (PD) in our hospital has increased during the past 5 years, but the number discontinuing PD has also increased. The purpose of this study was to identify the risk factors for PD discontinuation by analyzing the association between technical survival period (defined as the duration of PD) and various clinical factors.
We retrospectively investigated 87 patients who were started on PD at our hospital and attended regularly from April 2015 to March 2020, and we analyzed the association between technical survival period and various clinical factors. We also looked for associations between technical survival period and hospitalizations for heart failure, peritonitis, and exit-site infections among patients undergoing PD.
The patients using renin-angiotensin-aldosterone system inhibitors (RASi) (P = 0.0218), those with left ventricular ejection fraction (LVEF) > 50% (P = 0.0194) when they started PD, and those with estimated glomerular filtration rate (eGFR) ≥ 6 (mL/min/1.73 m) (P = 0.0013) at the initiation of PD showed significantly longer technical survival period, and those who were hospitalized for heart failure had significantly shorter period (P = 0.0008).
Treatment of RASi, LVEF > 50% and eGFR ≥ 6 mL/ min/1.73 m when the initiation of PD and better volume control to prevent ultrafiltration failure and heart failure may improve technical survival period in patients undergoing PD.
在过去的 5 年中，我院腹膜透析（PD）患者数量有所增加，但 PD 中断人数也有所增加。本研究旨在通过分析技术生存时间（定义为 PD 持续时间）与各种临床因素之间的关系，确定 PD 中断的危险因素。
我们回顾性调查了 2015 年 4 月至 2020 年 3 月在我院开始 PD 并定期就诊的 87 例患者，并分析了技术生存时间与各种临床因素之间的关系。我们还观察了 PD 患者心力衰竭、腹膜炎和出口部位感染住院次数与技术生存时间之间的关系。
使用肾素-血管紧张素-醛固酮系统抑制剂（RASi）的患者（P=0.0218）、开始 PD 时左心室射血分数（LVEF）>50%的患者（P=0.0194）和开始 PD 时估算肾小球滤过率（eGFR）≥6（mL/min/1.73 m）的患者（P=0.0013）技术生存时间明显延长，因心力衰竭住院的患者技术生存时间明显缩短（P=0.0008）。
开始 PD 时使用 RASi、LVEF>50%和 eGFR≥6 mL/min/1.73 m，以及更好的容量控制以预防超滤衰竭和心力衰竭，可能会改善 PD 患者的技术生存时间。
