Leaños-Miranda A
Hospital General de Zona No. 1-A Los venados, Instituto Mexicano del Seguro Social, México, D.F.
Rev Invest Clin. 1997 Sep-Oct;49(5):355-60.
To determine the factors associated with survival in a cohort of 74 patients with end-stage renal disease (ESRD) undergoing chronic peritoneal dialysis (CPD).
The study was carried out at a general hospital of the Instituto Mexicano del Seguro Social.
Analysis of a retrolective cohort under a nested case control design.
The variables studied included age, gender, cause of ESRD (diabetic or non-diabetic), socioeconomic status, modality of CPD (intermittent vs continuous ambulatory peritoneal dialysis), catheters per patient, rate of peritonitis, levels of serum creatinine and albumin at the beginning of the CPD.
During a 75.1 years-patient follow up, there were 41 deaths (cases). The main cause of death was peritonitis. The cumulated survival of the 74 patients was 64%, 29% and 13% at 12, 24 and 33 months, respectively. Intermittent peritoneal dialysis, the rate of peritonitis and the level of basal serum albumin were associated with a decreased survival in a univariate analysis. Only a high rate of peritonitis was associated with an increase in mortality rate independent from other variables (p = 0.002).
The probability of survival in ESRD in our hospital was low in relation to other nephrology departments of Mexico and other countries. A high rate of peritonitis proved to be an important independent predictor of a lesser survival rate in patients under CPD in our institution.
确定74例接受慢性腹膜透析（CPD）的终末期肾病（ESRD）患者队列中与生存相关的因素。
该研究在墨西哥社会保障局综合医院开展。
采用巢式病例对照设计对回顾性队列进行分析。
所研究的变量包括年龄、性别、ESRD病因（糖尿病性或非糖尿病性）、社会经济状况、CPD方式（间歇性与持续性非卧床腹膜透析）、每位患者的导管数量、腹膜炎发生率、CPD开始时的血清肌酐和白蛋白水平。
在75.1年的患者随访期间，有41例死亡（病例）。主要死亡原因是腹膜炎。74例患者在12、24和33个月时的累积生存率分别为64%、29%和13%。单因素分析显示，间歇性腹膜透析、腹膜炎发生率和基础血清白蛋白水平与生存率降低相关。仅腹膜炎的高发生率与死亡率增加相关，且独立于其他变量（p = 0.002）。
与墨西哥和其他国家的其他肾脏病科相比，我院ESRD患者的生存概率较低。腹膜炎的高发生率被证明是我院接受CPD治疗患者生存率较低的重要独立预测因素。
