老年腹膜透析患者的结局：65-74 岁与≥75 岁比较。
Outcomes of elderly peritoneal dialysis patients: 65-74 years old versus ≥ 75 years old.
机构信息
The Second Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
Ren Fail. 2023;45(2):2264977. doi: 10.1080/0886022X.2023.2264977. Epub 2023 Oct 5.
OBJECTIVE
To analyze the clinical data of elderly patients with peritoneal dialysis (PD) and compare patient and technique survival rates between Group 1 (65-74 years old) and Group 2 (≥75 years old).
METHODS
This retrospective study enrolled 296 elderly patients (≥65 years old) on maintenance PD who were admitted to the Peritoneal Dialysis Center of the Second Hospital of Soochow University. The patients were categorized by outcome into ongoing PD, changed to hemodialysis, renal recovery dialysis stopped, or death groups. The patients were divided into Group 1 (65-74 years old) and Group 2 (≥75 years old). Patient survival and technique survival rates were calculated by the Kaplan-Meier method. Factors associated with patient survival were analyzed using the Cox regression model.
RESULTS
There were 176 (59.5%) subjects in Group 1 and 120 (40.5%) subjects in Group 2. The primary causes of death were cardiovascular events, peritonitis, and other infections. The patient survival rates at 1, 3, and 5 years were 91.2%, 68.0%, and 51.3% in Group 1 and 76.8%, 37.5%, and 17.6% in Group 2 ( < 0.001, HR 0.387, 95% CI 0.282-0.530). There was no statistically significant difference in the technique survival rate between the two groups ( = 0.54).
CONCLUSION
The elderly PD patients in this cohort mostly died from cardiovascular events, with a higher patient survival rate in Group 1 and similar technique survival in both groups. Older age, lower prealbumin, higher creatinine, not being on activated vitamin D, and high Charlson's comorbidity index (CCI) score were independent risk factors for death.
目的
分析老年腹膜透析（PD）患者的临床资料，并比较 65-74 岁组（Group 1）和≥75 岁组（Group 2）患者和技术的生存率。
方法
本回顾性研究纳入了 296 名在苏州大学第二医院腹膜透析中心接受维持性 PD 的≥65 岁老年患者。根据结局将患者分为继续 PD、转为血液透析、肾功能恢复透析停止和死亡组。将患者分为 Group 1（65-74 岁）和 Group 2（≥75 岁）。通过 Kaplan-Meier 法计算患者生存率和技术生存率。采用 Cox 回归模型分析与患者生存率相关的因素。
结果
Group 1 中有 176 例（59.5%）患者，Group 2 中有 120 例（40.5%）患者。死亡的主要原因是心血管事件、腹膜炎和其他感染。Group 1 患者的 1、3、5 年生存率分别为 91.2%、68.0%和 51.3%，Group 2 患者的生存率分别为 76.8%、37.5%和 17.6%（ < 0.001，HR 0.387，95% CI 0.282-0.530）。两组间技术生存率无统计学差异（ = 0.54）。
结论
该队列中的老年 PD 患者主要死于心血管事件，Group 1 的患者生存率较高，两组的技术生存率相似。年龄较大、白蛋白前体较低、肌酐较高、未使用活性维生素 D 和 Charlson 合并症指数（CCI）评分较高是死亡的独立危险因素。
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