Struijk D G, Krediet R T, Koomen G C, Boeschoten E W, Arisz L
Department of Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Perit Dial Int. 1994;14(2):121-6.
To analyze the effect of serum albumin using immunoturbidimetry, demographic, biochemical, and kinetic factors on survival of continuous ambulatory peritoneal dialysis (CAPD) patients.
A review of prospectively collected data in a 2-year follow-up study of peritoneal transport kinetics.
University medical center.
Sixty-one patients, evaluated within 3 months after the start of CAPD.
Covariables used in the survival analysis were plasma urea, and creatinine, albumin, hemoglobin, mass transfer area coefficient of creatinine, peritoneal albumin clearance, 4-hour peritoneal albumin loss, net ultrafiltration, age, blood pressure, body mass index, difference between actual and ideal bodyweight, and presence or absence of systemic disease.
Overall survival was 64% at 2 years. Median serum albumin was 30.9 g/L, range 18.1-43.9 g/L. Patients with a serum albumin below the median had a lower survival rate than those higher than the median (2-year survival 49% vs 79%, p = 0.01). Using the Cox model, survival was related to systemic disease (p = 0.004), age (p = 0.02), hemoglobin (p = 0.03), and serum albumin (p = 0.1).
The results confirm the strength of serum albumin as predictor of survival. However, in this study serum albumin merely reflected the presence of a systemic disease, which was the most important risk factor for patient survival.
分析采用免疫比浊法测定的血清白蛋白、人口统计学、生化及动力学因素对持续性非卧床腹膜透析（CAPD）患者生存的影响。
对一项为期2年的腹膜转运动力学随访研究中前瞻性收集的数据进行回顾。
大学医学中心。
61例患者，在开始CAPD后3个月内接受评估。
生存分析中使用的协变量包括血浆尿素、肌酐、白蛋白、血红蛋白、肌酐的物质转运面积系数、腹膜白蛋白清除率、4小时腹膜白蛋白丢失量、净超滤量、年龄、血压、体重指数、实际体重与理想体重之差以及是否存在全身性疾病。
2年时总生存率为64%。血清白蛋白中位数为30.9 g/L，范围为18.1 - 43.9 g/L。血清白蛋白低于中位数的患者生存率低于高于中位数的患者（2年生存率49%对79%，p = 0.01）。使用Cox模型，生存与全身性疾病（p = 0.004）、年龄（p = 0.02）、血红蛋白（p = 0.03）和血清白蛋白（p = 0.1）有关。
结果证实血清白蛋白作为生存预测指标的有效性。然而，在本研究中血清白蛋白仅反映了全身性疾病的存在，而全身性疾病是患者生存的最重要危险因素。
