Chang Hsiao-Huang, Chang Ching-Hsiang, Hsiao Chen-Yuan, Kao Shih-Yi, Chen Jinn-Yang, Chen Tien-Hua, Tsai Pei-Jiun
Division of Cardiovascular Surgery, Department of Surgery, Veterans General Hospital, Taipei, Taiwan.
School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Front Med (Lausanne). 2021 Oct 27;8:719345. doi: 10.3389/fmed.2021.719345. eCollection 2021.
Peritoneal dialysis (PD) is a kind of renal replacement therapy for end-stage renal disease (ESRD). While PD has many advantages, various complications may arise. This retrospective study analyzed the complications of ESRD patients who received PD catheter implantation in a single medical center within 15 years. This study collected 707 patients. In the first 14 days after PD implantation, 54 patients experienced bleeding complications, while 47 patients experienced wound infection. Among all complications, catheter-related infections were the most common complication 14 days after PD implantation (incidence: 38.8%). A total of 323 patients experienced PD catheter removal, of which 162 patients were due to infection, while 96 were intentional due to kidney transplantation. Excluding those whose catheters were removed due to transplantation, the median survival of the PD catheter was 4.1 years; among them, patients without diabetes mellitus (DM) were 7.4 years and patients with DM were 2.5 years ( < 0.001). Further, 50% probability of surviving was beyond 3.5 years in DM patients with HbA1CC < 7 and 1.6 years in DM patients with HbA1C <7 ( ≥ 0.001). Catheter-related infections were the most common complications following PD catheter implantation. DM, especially with HbA1C ≥7, significantly impacted on the catheter-related infection and the survival probability of the PD catheter.
腹膜透析(PD)是终末期肾病(ESRD)的一种肾脏替代治疗方法。虽然腹膜透析有许多优点,但也可能出现各种并发症。这项回顾性研究分析了在单一医疗中心15年内接受PD导管植入的ESRD患者的并发症。本研究收集了707例患者。在PD植入后的前14天,54例患者出现出血并发症,47例患者出现伤口感染。在所有并发症中,导管相关感染是PD植入后14天最常见的并发症(发生率:38.8%)。共有323例患者拔除了PD导管,其中162例是由于感染,96例是因肾移植而有意拔除。排除因移植而拔除导管的患者,PD导管的中位生存期为4.1年;其中,非糖尿病(DM)患者为7.4年,糖尿病患者为2.5年(<0.001)。此外,糖化血红蛋白A1C(HbA1C)<7的糖尿病患者导管存活50%概率超过3.5年,HbA1C≥7的糖尿病患者为1.6年(≥0.001)。导管相关感染是PD导管植入后最常见的并发症。糖尿病,尤其是HbA1C≥7的糖尿病,对导管相关感染和PD导管的存活概率有显著影响。