Department of Nephrology, Kidney Hospital, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, China.
Clinical Research Center, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, China.
Ren Fail. 2022 Dec;44(1):252-257. doi: 10.1080/0886022X.2022.2033264.
Hypoalbuminemia at baseline is a powerful predictor of long-term outcomes in peritoneal dialysis patients. However, the levels of serum albumin are dynamically changed during PD. The present study investigated whether the improvement of hypoalbuminemia during PD can affect the patients' outcomes.
436 consecutive incidents continuous ambulatory peritoneal dialysis patients were involved in this study. Demographic, hematologic, biochemical, and dialysis-related data at baseline as well as 1 year after PD were collected. All patients were followed for at least 1 year for mortality.
Among the 436 patients, the mean age was 48.44 ± 14.98 years, with 58.26% males and 18.12% prevalence of diabetes. The mean follow-up time was 48.25 ± 24.05 months. During the follow-up period, a total of 68 patients died. Serum albumin was 34.35 ± 5.65 g/L at baseline, which increased to 37.39 ± 5.05 g/L at 1 year after PD. Multivariate linear regression analysis showed that sex, age, BMI, diabetic nephropathy, as well as albumin at baseline were independently associated with albumin at 1 year. Every 1 year of age rise would result in a 3.9% increase in the risk of mortality (HR = 1.039, 95%CI 1.016-1.061, = 0.001). Every 1 g/L increase in albumin at 1 year after PD confers an 8.7% decrease in the risk of mortality (HR = 0.913, 95%CI 0.856-0.973, = 0.005).
The level of serum albumin was increased in the first year of PD. Serum albumin after 1 year of PD predicted mortality in peritoneal dialysis.
基线时低白蛋白血症是腹膜透析患者长期预后的有力预测指标。然而，血清白蛋白水平在 PD 期间会发生动态变化。本研究旨在探讨 PD 期间低白蛋白血症的改善是否会影响患者的预后。
本研究纳入了 436 例连续发生的持续性不卧床腹膜透析患者。收集患者基线及 PD 后 1 年的人口统计学、血液学、生化和透析相关数据。所有患者均至少随访 1 年以观察死亡率。
436 例患者中，平均年龄为 48.44±14.98 岁，男性占 58.26%，糖尿病患病率为 18.12%。平均随访时间为 48.25±24.05 个月。随访期间，共有 68 例患者死亡。患者基线时血清白蛋白为 34.35±5.65 g/L，PD 后 1 年时增加至 37.39±5.05 g/L。多因素线性回归分析显示，性别、年龄、BMI、糖尿病肾病以及基线时白蛋白与 PD 后 1 年时白蛋白独立相关。年龄每增加 1 岁，死亡风险增加 3.9%（HR=1.039，95%CI 1.016-1.061，P=0.001）。PD 后 1 年时白蛋白每增加 1 g/L，死亡风险降低 8.7%（HR=0.913，95%CI 0.856-0.973，P=0.005）。
PD 治疗的第 1 年内血清白蛋白水平升高。PD 治疗 1 年后的血清白蛋白水平可预测腹膜透析患者的死亡率。
