Gamba G, Mejía J L, Saldívar S, Peña J C, Correa-Rotter R
Department of Nephrology and Mineral Metabolism, Instituto National de la Nutrición Salvador Zubirán, México D.F.
Nephron. 1993;65(1):23-7. doi: 10.1159/000187435.
The characteristics, survival rate and risk factors associated with death in patients with end-stage renal failure treated with chronic ambulatory peritoneal dialysis (CAPD) were studied. This is a retrospective study of a cohort of 206 patients, from which the follow-up was complete in 190 patients (92%). Only 16 patients (8%) were lost. The study group is composed of 118 males and 88 females, with a mean age of 39 +/- 15 years. The origin of the renal disease was: unknown in 90 patients (44%); diabetes mellitus in 50 (24%); systemic lupus erythematosus in 16 (8%); obstructive uropathy in 15 (7%); glomerulonephritis in 14 (7%), and miscellaneous in 21 (10%). The average follow-up was 12 +/- 11 months. At the end of study, 66 patients were dead (32%). CAPD was discontinued in 12 (6%). Thirty-eight patients (18%) received kidney transplantation. The survival rate for the whole group was 67 and 48% at 1 and 3 years, respectively. Multivariate survival analysis according to the Cox proportional-hazard model showed that the most powerful predictor associated with high risk of death was low serum albumin levels. According to the Cox model other independent variables significantly associated with increase in the probability of death while on CAPD were advancing age, low serum creatinine concentrations and elevated serum cholesterol levels. These results indicate that the risk factors associated with death in CAPD patients are similar to those observed for hemodialysis patients and suggest that using simple laboratory measurements at the enrollment in CAPD the relative risk of death for each patient can be estimated.
对接受持续性非卧床腹膜透析（CAPD）治疗的终末期肾衰竭患者的特征、生存率及死亡相关危险因素进行了研究。这是一项对206例患者队列的回顾性研究，其中190例患者（92%）随访完整，仅16例患者（8%）失访。研究组由118例男性和88例女性组成，平均年龄为39±15岁。肾脏疾病的病因如下：90例患者（44%）病因不明；50例（24%）为糖尿病；16例（8%）为系统性红斑狼疮；15例（7%）为梗阻性尿路病；14例（7%）为肾小球肾炎；21例（10%）为其他杂症。平均随访时间为12±11个月。研究结束时，66例患者死亡（32%）。12例患者（6%）停止了CAPD治疗。38例患者（18%）接受了肾移植。整个组在1年和3年时的生存率分别为67%和48%。根据Cox比例风险模型进行的多变量生存分析显示，与高死亡风险相关的最有力预测因素是血清白蛋白水平低。根据Cox模型，在进行CAPD治疗时，其他与死亡概率增加显著相关的独立变量包括年龄增长、血清肌酐浓度低和血清胆固醇水平升高。这些结果表明，CAPD患者的死亡相关危险因素与血液透析患者观察到的相似，提示在CAPD治疗开始时使用简单的实验室检测可以估计每个患者的相对死亡风险。
