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腹膜透析患者腹膜炎危险因素分析。

Analysis of risk factor for peritonitis in peritoneal dialysis patients.

作者信息

Ding Yanqiong, Tian Hongdan, Luo Qing, Zhang Yanmin, Li Hongbo, Wan Sheng, Li Lulu, Sun Li

机构信息

Department of Nephrology, Wuhan No. 1 Hospital Wuhan 430022, Hubei, China.

Department of Internal Medicine, Wuhan University Hospital Wuhan 430071, Hubei, China.

出版信息

Am J Transl Res. 2024 Nov 15;16(11):6964-6971. doi: 10.62347/EDBZ3412. eCollection 2024.

Abstract

OBJECTIVE

To investigate the risk factors for peritonitis in peritoneal dialysis patients and to develop and validate a predictive model.

METHODS

A total of 219 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) who had their first peritoneal dialysis catheter placement and regular follow-up at Wuhan No. 1 Hospital between April 2020 and August 2023 were included in this study. Patients were categorized into two groups: a peritoneal dialysis-associated peritonitis (PDAP) group and a non-PDAP group, based on the occurrence of PDAP. Univariate and multivariate logistic regression analyses were conducted to identify risk factors for PDAP in peritoneal dialysis patients. A risk prediction model was constructed, and its predictive performance was assessed using the receiver operating characteristic (ROC) curve.

RESULTS

Among the study population, 59 patients developed PDAP, with an incidence rate of 26.94%. Univariate and multivariate Logistic regression analyses identified serum albumin, age, hemoglobin, diabetes mellitus, and dialysis duration as independent risk factors for PDAP (all ). The ROC curve analysis of the predictive model yielded an area under the curve (AUC) of 0.914. A validation cohort consisting of 75 patients who underwent peritoneal dialysis between September 2023 and May 2024 included 22 PDAP. In this validation set, the predictive model achieved an AUC of 0.883 for PDAP.

CONCLUSION

Serum albumin, age, hemoglobin, diabetes, and dialysis duration are independent risk factors for PDAP in peritoneal dialysis patients. The developed predictive model demonstrates strong performance in identifying patients at high risk for PDAP.

摘要

目的

探讨腹膜透析患者腹膜炎的危险因素,并建立和验证预测模型。

方法

本研究纳入了2020年4月至2023年8月期间在武汉市第一医院首次置入腹膜透析导管并接受定期随访的219例持续非卧床腹膜透析(CAPD)患者。根据是否发生腹膜透析相关腹膜炎(PDAP),将患者分为两组:PDAP组和非PDAP组。进行单因素和多因素逻辑回归分析,以确定腹膜透析患者发生PDAP的危险因素。构建风险预测模型,并使用受试者工作特征(ROC)曲线评估其预测性能。

结果

在研究人群中,59例患者发生了PDAP,发病率为26.94%。单因素和多因素逻辑回归分析确定血清白蛋白、年龄、血红蛋白、糖尿病和透析时间为PDAP的独立危险因素(均为……)。预测模型的ROC曲线分析得出曲线下面积(AUC)为0.914。一个由75例在2023年9月至2024年5月期间接受腹膜透析的患者组成的验证队列中包括22例PDAP患者。在该验证集中,预测模型对PDAP的AUC为0.883。

结论

血清白蛋白、年龄、血红蛋白、糖尿病和透析时间是腹膜透析患者发生PDAP的独立危险因素。所建立的预测模型在识别PDAP高危患者方面表现出强大的性能。

相似文献

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本文引用的文献

1
SAGES peritoneal dialysis access guideline update 2023.2023年SAGES腹膜透析通路指南更新
Surg Endosc. 2024 Jan;38(1):1-23. doi: 10.1007/s00464-023-10550-8. Epub 2023 Nov 21.
2
Incremental peritoneal dialysis: Incremental gains.增量腹膜透析:渐进性获益。
Perit Dial Int. 2023 Sep;43(5):355-358. doi: 10.1177/08968608231195464.
10
Scrotal abscess complicating peritoneal dialysis-associated peritonitis.阴囊脓肿并发腹膜透析相关性腹膜炎。
Perit Dial Int. 2023 Jan;43(1):110-111. doi: 10.1177/08968608221125594. Epub 2022 Sep 22.

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