Marcelli D, Spotti D, Conte F, Tagliaferro A, Limido A, Lonati F, Malberti F, Locatelli F
Perit Dial Int. 1996;16 Suppl 1:S283-7.
Our objective was to analyze the survival of diabetic patients on renal replacement therapy and to compare their survival on extracorporeal and on peritoneal dialysis. All data regarding diabetic patients admitted to dialysis between 1 January 1983 and 31 December 1993 were collected by means of individual patient questionnaires sent to all of the 44 regional Renal Units (100% answers) of Lombardy, Italy. Cox proportional hazards model, stepwise procedure, was applied in order to select the covariates significantly associated with survival. Age (at baseline), sex, type of diabetes, initial modality of treatment (hemodialysis or peritoneal dialysis), and initial clinical risk factors (malignancies, serious heart disease, vascular disease, cirrhosis of the liver, cachexia) were considered. Descriptive analysis of survival was performed using the Kaplan-Meier technique. The survival of all diabetic patients (895) was 86.5% at one year, 52% at three years, and 34% at five years. The main causes of the 488 deaths of diabetic patients were cardiovascular diseases (56%), cachexia (18%), and infections (11%). The relative death risk of patients on peritoneal dialysis versus those on hemodialysis, after taking into account the main comorbid conditions, did not significantly differ from 1, as estimated by the Cox proportional hazards regression model. Five-year survival of diabetic patients was 34%, and no differences were found between peritoneal dialysis and hemodialysis as far as mortality is concerned.
我们的目标是分析接受肾脏替代治疗的糖尿病患者的生存率，并比较他们在体外透析和腹膜透析时的生存率。通过向意大利伦巴第地区所有44个肾脏科室（回复率100%）发放个体患者问卷，收集了1983年1月1日至1993年12月31日期间接受透析治疗的糖尿病患者的所有数据。应用Cox比例风险模型的逐步程序来选择与生存率显著相关的协变量。考虑的因素包括年龄（基线时）、性别、糖尿病类型、初始治疗方式（血液透析或腹膜透析）以及初始临床风险因素（恶性肿瘤、严重心脏病、血管疾病、肝硬化、恶病质）。使用Kaplan-Meier技术对生存率进行描述性分析。所有糖尿病患者（895例）的一年生存率为86.5%，三年生存率为52%，五年生存率为34%。488例糖尿病患者死亡的主要原因是心血管疾病（56%）、恶病质（18%）和感染（11%）。根据Cox比例风险回归模型估计，在考虑主要合并症后，腹膜透析患者与血液透析患者的相对死亡风险与1无显著差异。糖尿病患者的五年生存率为34%，就死亡率而言，腹膜透析和血液透析之间未发现差异。
