Zhou Lei, Wang Xiaoyang, Zhan Xiaojiang, Feng Xiaoran, Wang Niansong, Peng Fenfen, Wen Yueqiang, Wu Xianfeng
Evergreen Tree Nephrology Association, Guangzhou, China.
Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
EClinicalMedicine. 2021 Sep 16;41:101133. doi: 10.1016/j.eclinm.2021.101133. eCollection 2021 Nov.
Lower serum chloride is associated with a higher risk of mortality in the general population. However, the association has received little attention in peritoneal dialysis patients. The study aimed to examine the association between serum chloride and mortality in peritoneal dialysis patients.
In this multicenter retrospective cohort study, 2376 Chinese incident patients on peritoneal dialysis between January 1, 2005, and March 31, 2020, were included. Patients were grouped according to quartiles of serum chloride at baseline. The associations of baseline serum chloride and cardiovascular mortality and all-cause mortality were evaluated using cause-specific hazards models.
Of 2376 patients, the mean age was 45.9 (45.3,46.5) years, 50.1% of patients were men. The median serum chloride levels were 103.0 (99.0,106.9) mmol/L. During 9304.5 person-years of follow-up, 462 patients died, of which 235 deaths were caused by cardiovascular disease. The highest quartile group was associated with a higher risk of cardiovascular mortality (adjusted hazards ratio [HR], 2.95; 95% confidence interval [CI], 1.80 to 4.95) and all-cause mortality (adjusted HR, 2.03; 95% CI, 1.45 to 2.83) compared with the lowest quartile. The similar trend was also found when serum chloride levels were deal as continuous variable.
Higher serum chloride at the initial of peritoneal dialysis was associated with a higher risk of cardiovascular mortality and all-cause mortality in patients on peritoneal dialysis.
This work was supported by Shanghai Municipal Health Commission (2019SY018).
在普通人群中，较低的血清氯与较高的死亡风险相关。然而，这种关联在腹膜透析患者中很少受到关注。本研究旨在探讨腹膜透析患者血清氯与死亡率之间的关联。
在这项多中心回顾性队列研究中，纳入了2005年1月1日至2020年3月31日期间开始腹膜透析的2376例中国患者。患者根据基线时血清氯的四分位数进行分组。使用特定病因风险模型评估基线血清氯与心血管死亡率和全因死亡率之间的关联。
2376例患者的平均年龄为45.9（45.3，46.5）岁，50.1%为男性。血清氯中位数水平为103.0（99.0，106.9）mmol/L。在9304.5人年的随访期间，462例患者死亡，其中235例死于心血管疾病。与最低四分位数组相比，最高四分位数组的心血管死亡率（调整后风险比[HR]，2.95；95%置信区间[CI]，1.80至4.95）和全因死亡率（调整后HR，2.03；95%CI，1.45至2.83）风险更高。当将血清氯水平作为连续变量处理时，也发现了类似趋势。
腹膜透析开始时较高的血清氯与腹膜透析患者的心血管死亡率和全因死亡率较高相关。
本研究得到上海市卫生健康委员会（2019SY018）的支持。
