Hospital Health Research and Practice Center, Faculty of Medicine, Trakya University, Edirne 22030, Turkey.
Department of Pulmonary Diseases, Faculty of Medicine, Trakya University, Edirne 22030, Turkey.
Medicina (Kaunas). 2024 Aug 16;60(8):1331. doi: 10.3390/medicina60081331.
: This study aims to analyze survival in peritoneal and hemodialysis patients using chest radiography and biochemical parameters, determine common dialysis etiologies and causes of death, reveal prognostic factors, and contribute to clinical practice. : A retrospective cross-sectional study was conducted with data from 33 peritoneal dialysis and 37 hemodialysis patients collected between October 2018 and February 2020. Survival and mortality were retrospectively tracked over 70 months (October 2018-June 2024). Chest X-ray measurements (cardiothoracic index, pulmonary vascular pedicle width, right pulmonary artery diameter, diaphragmatic height) and biochemical parameters (urea, albumin, creatinine, parathormone, ferritin, hemoglobin, arterial blood gas, potassium) were analyzed for their impact on survival. Statistical analyses included descriptive statistics, chi-square test, Fisher's exact test, Bayesian analysis, McNemar test, Kaplan-Meier survival analysis, Cox regression, Bayesian correlation test, linear regression analysis (scatter plot), and ROC analysis. SPSS 20.0 was used for data analysis, with < 0.05 considered statistically significant. : Hypertension, type 2 diabetes, and urogenital disorders were the main dialysis etiologies. Peritonitis (38.5%) and cardiovascular diseases (47.4%) were the leading causes of death in peritoneal and hemodialysis patients, respectively. Significant chest X-ray differences included pulmonary vascular pedicle width and pulmonary artery diameter in hemodialysis and diaphragm height in peritoneal dialysis. Kaplan-Meier showed no survival difference between methods. Cox regression identified age, intact parathormone levels, iPTH/PVPW ratio, and clinical status as survival and mortality factors. The iPTH/PVPW ratio cut-off for mortality prediction was ≤6.8. : Age, intact parathormone levels, pulmonary vascular pedicle width, and clinical status significantly impact survival in dialysis patients. Management of hypertension and diabetes, management and follow-up of urogenital disorders, infection control, patient education, and regular cardiovascular check-ups may improve survival rates. Additionally, the iPTH/PVPW ratio can predict mortality risk.
: 本研究旨在通过胸部 X 射线和生化参数分析腹膜透析和血液透析患者的生存率，确定常见的透析病因和死亡原因，揭示预后因素，并为临床实践提供参考。 : 这是一项回顾性的横断面研究，纳入了 2018 年 10 月至 2020 年 2 月期间收集的 33 例腹膜透析和 37 例血液透析患者的数据。对患者进行了 70 个月（2018 年 10 月至 2024 年 6 月）的生存和死亡跟踪。分析了胸部 X 射线测量值（心胸指数、肺血管蒂宽度、右肺动脉直径、膈肌高度）和生化参数（尿素、白蛋白、肌酐、甲状旁腺激素、铁蛋白、血红蛋白、动脉血气、钾）对生存率的影响。统计分析包括描述性统计、卡方检验、Fisher 确切检验、贝叶斯分析、McNemar 检验、Kaplan-Meier 生存分析、Cox 回归、贝叶斯相关检验、线性回归分析（散点图）和 ROC 分析。采用 SPSS 20.0 进行数据分析， < 0.05 表示具有统计学意义。 : 高血压、2 型糖尿病和泌尿生殖系统疾病是主要的透析病因。腹膜炎（38.5%）和心血管疾病（47.4%）分别是腹膜透析和血液透析患者死亡的主要原因。血液透析患者的胸部 X 射线差异有显著意义的指标包括肺血管蒂宽度和肺动脉直径，腹膜透析患者的指标为膈肌高度。Kaplan-Meier 分析显示两种透析方法之间的生存率无差异。Cox 回归分析确定了年龄、完整甲状旁腺激素水平、iPTH/PVPW 比值和临床状态是生存和死亡的影响因素。iPTH/PVPW 比值预测死亡率的截断值为 ≤6.8。 : 年龄、完整甲状旁腺激素水平、肺血管蒂宽度和临床状态显著影响透析患者的生存率。管理高血压和糖尿病、泌尿生殖系统疾病的管理和随访、感染控制、患者教育和定期心血管检查可能会提高生存率。此外，iPTH/PVPW 比值可以预测死亡风险。
