Wu A H, Mu X D, Chao W Y, Lu P Y, Yang M, Zhou H
Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou 213003, China.
Zhonghua Yi Xue Za Zhi. 2023 Mar 14;103(10):720-726. doi: 10.3760/cma.j.cn112137-20221017-02163.
To explore the predictive value of controlling nutritional status (CONUT) score and dialysis age for peritoneal dialysis-associated peritonitis (PDAP). This study was a follow-up study. Patients with end-stage renal disease who received peritoneal dialysis (PD) for the first time in the Department of Nephrology, the Third Affiliated Hospital of Suzhou University from January 2010 to December 2020 were enrolled in the study. Patients were divided into non-peritonitis group, mono group (only once PDAP occurred in one year) and frequent group (twice or more PDAP occurred in one year) according to the occurrence and frequency of PDAP during follow-up. The demographic, clinical and laboratory data of patients were collected, and the body mass index and CONUT score were recorded after half a year. Cox regression analysis was used to screen the relevant factors, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of CONUT score and dialysis age for PDAP. A total of 324 PD patients were included, with 188 males (58.0%) and 136 females (42.0%), and aged［（，）］48 (37, 60) years old. The follow-up time was 33 (19, 56) months. PDAP occurred in 112 patients (34.6%), including 63 patients (19.4%) in mono group and 49 patients (15.1%) in frequent group. Multivariate Cox regression analysis showed that half-year CONUT score (=1.159, 95%: 1.047-1.283, =0.004) was a risk factor for PDAP, and the baseline CONUT score (=1.194, 95% 1.012-1.408, =0.036) was a risk factor for frequent peritonitis. The area under ROC curve of baseline CONUT score combined with dialysis age in predicting PDAP and frequent peritonitis was 0.682 (95%: 0.628-0.733) and 0.676 (95%: 0.622-0.727), respectively. CONUT score and dialysis age have certain predictive value for PDAP, and the predictive value of combined diagnosis is higher, which may be used as a potential predictor for PDAP in PD patients.
探讨控制营养状态（CONUT）评分及透析龄对腹膜透析相关性腹膜炎（PDAP）的预测价值。本研究为一项随访研究。纳入2010年1月至2020年12月在苏州大学附属第三医院肾内科首次接受腹膜透析（PD）的终末期肾病患者。根据随访期间PDAP的发生情况及频率，将患者分为非腹膜炎组、单次组（一年内仅发生1次PDAP）和频发组（一年内发生2次或以上PDAP）。收集患者的人口统计学、临床和实验室资料，半年后记录体重指数及CONUT评分。采用Cox回归分析筛选相关因素，绘制受试者工作特征（ROC）曲线分析CONUT评分及透析龄对PDAP的预测价值。共纳入324例PD患者，其中男性188例（58.0%），女性136例（42.0%），年龄［（，）］48（37，60）岁。随访时间为33（19，56）个月。112例患者（34.6%）发生PDAP，其中单次组63例（19.4%），频发组49例（15.1%）。多因素Cox回归分析显示，半年CONUT评分（=1.159，95%可信区间：1.047 - 1.283，=0.004）是PDAP的危险因素，基线CONUT评分（=1.194，95%可信区间1.012 - 1.408，=0.036）是频发腹膜炎的危险因素。基线CONUT评分联合透析龄预测PDAP及频发腹膜炎的ROC曲线下面积分别为0.682（95%可信区间：0.628 - 0.733）和0.676（95%可信区间：0.622 - 0.727）。CONUT评分及透析龄对PDAP具有一定的预测价值，联合诊断的预测价值更高，可作为PD患者发生PDAP的潜在预测指标。
