Department of Nephrology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Department of Nephrology, South China Hospital, Medical School, Shenzhen University, Shenzhen, Guangdong, China.
Ren Fail. 2024 Dec;46(1):2353339. doi: 10.1080/0886022X.2024.2353339. Epub 2024 May 21.
Peritoneal dialysis (PD) serves as a vital renal replacement therapy for patients with end-stage kidney disease (ESKD). γ-Gamma-glutamyl transferase (γ-GGT) is a recognized predictor of oxidative stress and mortality. This study aimed to assess the prognostic significance of γ-GGT in predicting all-cause and cardiovascular mortality among PD patients.
A retrospective study was conducted, enrolling 640 PD patients from a single center. The one-year, three-year, and five-year mortality rates for all causes and cardiovascular causes were evaluated. Kaplan-Meier survival analysis and multivariate Cox regression analysis were performed.
Within five years of initiating PD, the observed all-cause mortality rates at one, three, and five years were 11.72%, 16.09%, and 23.44%, while cardiovascular mortality rates were 2.97%, 7.34%, and 11.09%, respectively. Lower γ-GGT levels were associated with decreased all-cause mortality during one-, three-, and five-year follow-ups, along with reduced cardiovascular mortality in the first and third years, as indicated by Kaplan-Meier analysis on median γ-GGT groupings. Multivariate Cox regression analysis showed significantly decreased hazard ratios (HRs) for one- to five-year all-cause mortality and cardiovascular mortality in the lower γ-GGT group compared to higher groups. However, when sex differences were eliminated using separate tertile groupings for males and females, only the one- and three-year all-cause mortality rates demonstrated significantly reduced hazard ratios (HRs) in the lower γ-GGT groups.
This retrospective study suggests that γ-GGT levels have prognostic significance in predicting one- and three-year all-cause mortality among PD patients when accounting for sex differences.
腹膜透析（PD）是终末期肾病（ESKD）患者重要的肾脏替代治疗方法。γ-谷氨酰转移酶（γ-GGT）是氧化应激和死亡率的公认预测因子。本研究旨在评估γ-GGT 在预测 PD 患者全因和心血管死亡率方面的预后意义。
本回顾性研究纳入了来自单中心的 640 名 PD 患者。评估了全因和心血管原因的一年、三年和五年死亡率。进行了 Kaplan-Meier 生存分析和多变量 Cox 回归分析。
在开始 PD 后的五年内，观察到的一年、三年和五年全因死亡率分别为 11.72%、16.09%和 23.44%，心血管死亡率分别为 2.97%、7.34%和 11.09%。Kaplan-Meier 分析中位数γ-GGT 分组显示，较低的γ-GGT 水平与随访 1 年、3 年和 5 年的全因死亡率降低相关，并且在第一年和第三年的心血管死亡率也降低。多变量 Cox 回归分析显示，与较高γ-GGT 组相比，较低γ-GGT 组的全因死亡率和心血管死亡率的危险比（HR）在 1 至 5 年的时间内显著降低。然而，当使用男性和女性的单独三分位组对性别差异进行消除后，仅在较低的γ-GGT 组中，全因死亡率的 1 年和 3 年的危险比（HR）显著降低。
本回顾性研究表明，当考虑性别差异时，γ-GGT 水平在预测 PD 患者 1 年和 3 年全因死亡率方面具有预后意义。
