Department of Nephrology, Second Affiliated Hospital of Soochow University, Suzhou, China,
Department of Nephrology, Second Affiliated Hospital of Soochow University, Suzhou, China.
Cardiorenal Med. 2021;11(4):200-207. doi: 10.1159/000516285. Epub 2021 Jul 28.
This study aimed to compare mortality between peritoneal dialysis (PD) patients with and without cardiac valve calcification (CVC).
Patients undergoing PD at the dialysis center of the Second Affiliated Hospital of Soochow University from January 1, 2009, to June 31, 2016, were included and followed through December 31, 2018. The inclusion criteria were (1) age ≥18 years and (2) PD vintage ≥1 month. The exclusion criteria were (1) a history of hemodialysis or renal transplantation before PD; (2) diagnosed congenital heart disease, rheumatic heart disease, or hyperthyroid heart disease; and (3) loss to follow-up. Differences in mortality rates were compared using a Fine-Gray proportional hazards model.
A total of 310 patient cases were included in this study, including 237 cases without CVC (non-CVC group). The CVC group included 59 cases with aortic valve calcification (AVC), 6 cases with mitral valve calcification (MVC), and 8 cases of AVC associated with MVC. After propensity score matching, 68 pairs were selected. The multivariate competing risk regression analysis revealed that age (hazard ratio [HR]: 1.06, 95% confidence interval [95% CI]: 1.03-1.10, p < 0.001) and CVC group (HR: 1.83, 95% CI: 1.04-3.20, p < 0.05) were independent risk factors associated with mortality. No significant difference was observed in technique survival between the 2 groups.
CVC is an independent risk factor for mortality in PD patients.
本研究旨在比较伴有和不伴有心脏瓣膜钙化（CVC）的腹膜透析（PD）患者的死亡率。
纳入 2009 年 1 月 1 日至 2016 年 6 月 31 日在苏州大学附属第二医院透析中心行 PD 的患者，并随访至 2018 年 12 月 31 日。纳入标准为：（1）年龄≥18 岁；（2）PD 龄≥1 个月。排除标准为：（1）PD 前有血液透析或肾移植史；（2）确诊先天性心脏病、风湿性心脏病或甲亢性心脏病；（3）失访。采用 Fine-Gray 比例风险模型比较死亡率差异。
本研究共纳入 310 例患者，其中 237 例无 CVC（非 CVC 组）。CVC 组包括 59 例主动脉瓣钙化（AVC）、6 例二尖瓣钙化（MVC）和 8 例 AVC 合并 MVC。经倾向评分匹配后，选择了 68 对。多变量竞争风险回归分析显示，年龄（风险比 [HR]：1.06，95%置信区间 [95%CI]：1.03-1.10，p<0.001）和 CVC 组（HR：1.83，95%CI：1.04-3.20，p<0.05）是与死亡率相关的独立危险因素。两组的技术生存率无显著差异。
CVC 是 PD 患者死亡的独立危险因素。
