43例不卧床持续性腹膜透析患者退出原因分析

目的:分析43例不卧床持续性腹膜透析(CAPD)患者退出透析的原因及其相关影响因素。方法:回顾性分析本中心2013年～2016年43例不卧床持续性腹膜透析(CAPD)患者退出透析,统计退出原因;比较退出组(研究组)和现存组(对照组)间的人口学资料、透析3个月时的血红蛋白、血清白蛋白、钙、磷、腹膜透析评估等相关临床指标,分析患者退出透析与其人口学资料和相关临床指标之间的相关性。结果:心血管疾病、透析不充分、感染、脑血管疾病是腹膜透析(CAPD)患者退出透析的主要原因;与现存组相比,退出组患者的KT/V值以及患者透析3个月时的血钾、白蛋白、iPTH均较低(P 0. 05),处于低平均转运的患者比例较高; Logistic回归分析显示结果,KT/V、血钾、iPTH及白蛋白是患者退出腹膜透析的独立影响因素(P 0. 05)。结论:在腹膜透析患者中,心脑血管疾病是患者退出透析的首要原因;低KT/V、低血钾、低iPTH以及低白蛋白是患者退出的独立影响因素。     

容量超负荷状态对持续性非卧床腹膜透析患者血清白蛋白水平的影响

目的：探讨容量超负荷状态对持续性非卧床腹膜透析（CAPD）患者血清白蛋白（Alb）水平的影响。方法：对2009年6月在北京大学附属第三医院肾内科接受持续性非卧床腹膜透析患者进行横断面调查。采用BCM系统测定患者体成份,并以OH（overhydration）作为容量状态的评估指标;同时收集空腹血、24 h尿液及透析引流液用于透析充分性评估、Alb及其他生化检测。采用均数比较及多因素分析等统计学方法探讨容量状态与Alb之间的关系。结果：共有129例符合条件的患者入选本研究。根据总体Alb平均水平将患者分为两组,即Alb≥39 g/L和Alb〈39 g/L。结果显示前者OH及年龄平均水平均明显小于后者[OH,（1.75±1.60）vs（3.16±1.88）L,P〈0.05;年龄,（58.1±14.2）vs（67.8±12.3）岁,P〈0.05];多因素分析提示,在矫正性别、糖尿病后,OH与年龄是影响患者血清白蛋白水平的独立危险因素（R2=0.301,P〈0.05）。结论：本研究表明容量超负荷是影响腹膜透析患者低白蛋白血症发生的独立危险因素,并且OH也许是评估腹膜透析人群容量状况的良好指标。     

腹膜溶质转运特性对腹膜透析患者营养指标的影响

目的探讨腹膜溶质转运特性对腹膜透析患者营养指标的影响.方法按照腹膜平衡试验(PET)计算结果,将68例稳定的连续性不卧床性腹膜透析(CAPD)患者分为高转运组(37例)和低转运组(31例).检测患者血浆和腹透透出液中的总蛋白、白蛋白及氨基酸量,同步计算蛋白质摄入量(DPI)和蛋白质分解率(nPCR).比较两组营养状态及进行相关因素分析.结果两组的残余肾功能、CAPD治疗时间、每日透析液剂量、超滤量、葡萄糖吸收量、血糖、尿素氮(BUN)、血清肌酐(Scr)和尿素清除指数(Kt/V)比较,差异无显著性意义(均P>0.05).高转运组每日经腹透透出液丢失的总蛋白质和多种氨基酸量显著高于低转运组(均P<0.05);各项营养指标均低于低转运组;两组体重及血清白蛋白比较,差异有显著性意义(均P<0.05).每日经腹透液丢失的Alb量和TAA与D/P4Scr呈正相关关系(均P<0.05).结论腹膜透析高转运患者营养指标较低转运者差,应加强对高转运患者的营养护理和指导;每日透析液量及超滤量能达到TCcr与DPI平衡即可,不宜盲目增加腹透液的剂量、浓度和存留时间,导致过度透析,引起蛋白质和氨基酸经腹透液大量丢失及吸收大量的葡萄糖,加重患者蛋白质缺乏性营养不良.     

不同腹膜溶质转运特性腹膜透析患者营养状况的比较

目的 探讨腹膜转运特性对腹膜透析患者营养状态的影响。方法 按照腹膜平衡试验(PET)计算结果,将82例稳定的CAPD患者分为高转运组和低转运组。检测患者血浆和腹透透出液总蛋白、白蛋白及氨基酸量,同步计算蛋白质摄入量(DPI)和蛋白质分解率(nPCR)。比较两组营养状态及分析相关因素。结果两组的残余肾功能、腹透治疗时间、每日透析液剂量、超滤量、葡萄糖吸收量、血糖、BUN、Scr和Kt／V均无显著性差异。高转运组每日经腹透透出液丢失的总蛋白质和多种氨基酸量明显高于低转运组;各项营养指标均低于低转运组,且体重及血清白蛋白有显著性差异。血中及经腹透透出液丢失的白蛋白和氨基酸量均与转运类型相关。结论 腹膜透析高转运患者营养状态较低转运者差。单纯提高透析充分性并不能明显改善营养状态。要加强对高转运患者的营养管理和指导。     

腹膜透析患者血清白蛋白变化与容量变化关系的临床纵向观察

目的:探讨持续性非卧床腹膜透析(CAPD)患者容量动态变化对血清白蛋白水平的影响。方法:对符合入选条件的129例来自南京医科大学附属淮安第一医院肾内科的CAPD患者随访18个月,每6个月对患者容量状态(overhydration,OH)、血清白蛋白(Alb)及透析充分性等指标进行监测。随访前后Alb的变化表示为ΔAlb(Alb18月~Alb0月),OH的变化表示为ΔOH(OH18月~OH0月)。结果:根据△Alb将患者分为三组,即A组(ΔAlb≥3 g/L)、B组(2 g/L≥ΔAlb≥-2 g/L)及C组(ΔAlb≤-3 g/L),结果显示ΔOH在三组间有明显不同[(-1.04±1.6)L,(0.16±1.62)L,(0.26±1.34)L;P0.05)],而患者年龄、透析龄及残余肾尿素清除率(r Kt/V)在各组间差异无统计学意义;基于基线资料的多因素线性回归分析提示OH、年龄及r Kt/V是影响Alb水平的独立因素(R2=0.301,P0.05);而Logistic回归分析表明在矫正性别、糖尿病及r Kt/v下降速率等因素后,随访期间平均OH水平是影响低白蛋白血症发生的独立危险因素(χ2=20.51,P0.05)。结论:腹膜透析患者持续高容量状态或容量负荷增加是导致低白蛋白血症发生的主要危险因素之一,而残肾功能下降并不一定伴有Alb水平的下降。     

中药艾灸改善腹膜透析患者营养不良的临床研究

目的：观察中药艾灸对高腹膜转运CAPD患者腹膜营养不良的影响.方法：高腹膜转运CAPD患者26例随机分为两组,治疗组（中药艾灸）与对照组各13例,观察治疗前后透析超滤量（UF）、C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、血清白蛋白（Alb）、前白蛋白（Pre-A）及中医症状计分和改良定量主观整体评估法（MQSGA）评分的变化.结果：治疗组治疗后24 h总超滤量明显增加,hs-CRP、IL-6明显下降,Alb及Pre-A明显增加,中医症状计分和MQSGA评分增加,优于对照组（P〈0.05）.结论：中药艾灸可以有效提高透析超滤量,减轻高腹膜转运CAPD患者的微炎症状态,改善营养不良.     

护理管理者应具备的管理技能调查分析

目的 探讨腹膜溶质转运特性对腹膜透析患者营养指标的影响。方法 按照腹膜平衡试验（PET）计算结果。将68例稳定的连续性不卧床性腹膜透析（CAPD）患者分为高转运组（37例）和低转运组（31例）。检测患者血浆和腹透选出液中的总蛋白、白蛋白及氨基酸量，同步计算蛋白质摄入量（DPI）和蛋白质分解率（nPCR）。比较两组营养状态及进行相关因素分析。结果 两组的残余肾功能、CAPD治疗时间、每日透析液剂量、超滤量、葡萄糖吸收量、血糖、尿素氯（BUN）、血清肌酐（Scr）和尿素清除指数（K1／V）比较，差异无显著性意义（均P〉0．05）。高转运组每日经腹透透出液丢失的总蛋白质和多种氨基酸量显著高于低转运组（均P＜0．05）；各项营养指标均低于低转运组；两组体重及血清白蛋白比较．差异有显著性意义（均P〈0．05）。每日经腹透波丢失的Alb量和TAA与D／PIScr呈正相关关系（均P〈0．05）。结论 腹膜透析高转运患者营养指标较低转运者差，应加强对高转运惠者的营养护理和指导；每日透析液量及超滤量能达到TCcr与DPI平衡即可．不宜盲目增加腹透液的剂量、浓度和存留时间．导致过度透析．引起蛋白质和氨基酸经腹透液大量丢失及吸收大量的葡萄糖．加重患者蛋白质缺乏性营养不良。     

浅谈腹膜透析患者的血压管理

腹膜透析患者的高血压患病率达80%以上,难治性高血压导致卒中、心血管事件发病率不断增加,是患者死亡和退出腹膜透析的主要原因。2015年国际腹膜透析协会(ISPD)关于成人腹膜透析患者心血管和代谢指南指出,持续腹膜透析患者目标血压应<140/90 mmHg,并与年龄无关。腹膜透析患者血压控制不佳的影响因素纷繁复杂,但常见原因是容量超负荷和残肾功能减退。腹膜透析患者高血压防治策略包括容量负荷的准确评估与干预、残余肾功能的有效保护、透析处方的及时调整,降压药物的正确选择以及以病人为中心的团队管理等五个方面。     

不同腹膜转运功能的腹膜透析患者的营养不良-微炎症状态评估

目的 评价不同腹膜转运特性的持续性非卧床腹膜透析(CAPD)患者的营养不良-微炎症状态.方法 选择本院稳定腹膜透析半年以上的患者170例,按照腹膜平衡试验计算结果,将患者分为高转运组、高平均转运组、低平均转运组和低转运组.对各组患者的营养及炎症指标进行检测,检测指标包括人体测量指标和生化指标,并根据营养不良-炎症评分表,对每组患者进行评分.对四组患者的各项指标进行方差分析,对各组间指标的均数进行两两比较,并将腹膜平衡试验的D/Pcr与营养不良-微炎症指标进行相关性分析,综合评估各组患者的营养不良-微炎症状态严重程度.结果 符合纳入标准的患者中高转运组24例、平均转运组42例、低平均转运组50例、低转运组54例.MIS分值越高,患者的营养状况越差,微炎症状态越严重,D/Pcr与PD患者人体测量指标、贫血指标和营养指标呈负相关,与炎症指标呈正相关.四组患者的相关指标均有显著性差异,按营养不良-微炎症状态的严重程度排列为:高转运＞高平均转运＞低平均转运＞低转运.结论 不同腹膜转运特性对腹膜透析患者的营养不良-微炎症状态有不同的影响,高通透性腹膜功能患者营养不良-微炎症状态较低通透性者差,故应加强对高通透性CAPD患者的腹透方案调整及营养管理.     

腹膜转运和营养状况在腹透充分性中的评价

持续不卧床腹膜透析(CAPD)患者普遍存在营养不良状态,本研究探讨腹膜转运特性对CAPD患者营养状况的影响,并分析两者在透析充分性判定中的地位。     

老年腹膜透析患者相关危险因素的分析

目的：探讨老年腹膜透析患者的相关危险因素。方法：通过观察分析危险因素：性别、原发病情况（糖尿病、高血压）、营养状态指标、贫血指标、腹膜透析充分性指标、钙磷代谢情况,并分析腹膜透析患者相关性感染及其心脑血管并发症情况。结果：高血糖、腹膜透析充分性（总Kt/V和总Ccr）及血浆白蛋白（Alb）成为腹膜透析患者老年组独立影响危险因素;另外,31例患者中有2例患者出现腹膜透析相关性腹膜炎情况,1例患者出现严重的脑血管并发症。结论：积极控制老年腹膜透析患者的血糖,并改善患者血清白蛋白及正确评估老年腹膜透析患者的透析充分性,这对于提高老年腹膜透析的生存质量具有重要作用。     

Relationship of peritoneal membrane transport characteristics to the nutritional status in CAPD patients.

BACKGROUND: The study was carried out to evaluate the role of individual peritoneal membrane transport characteristics in the nutritional status expressed as the composite nutritional index (CNI) METHODS: Cross-sectional analyses of the overall nutritional status of 147 continuous ambulatory peritoneal dialysis (CAPD) patients were performed using the CNI. CNIs based on a scoring system of 10 nutritional indices including subjective global assessment, biochemical parameters and anthropometry were compared according to the results of a standard peritoneal equilibration test (PET) RESULTS: Patients were classified as low (n = 16, 10.9%), low average (n=59, 40.2%), high average (n=54, 36.7%) and high (n=18, 12.2%) transporters based on the D/P(Cr) after 4 h dwells. The mean 4 h D/P(Cr) was 0.65 +/- 0.12 (0.34-0.95), and there was no significant correlation between D/P(Cr) and other demographic parameters such as age, duration of peritoneal dialysis and body surface area. D/P(Cr) was correlated with dialytic albumin loss (r=0.47, P<0.001), serum albumin (r=-0.46, P<0.001), serum creatinine (r= -0.38, P<0.001), serum TGF-1 (r=-0.37, P<0.01) and LBM(Cr) (r= -0.26, P<0.05). In high transporters, the serum albumin was significantly lower while dialysate protein and albumin losses were significantly greater compared with low transporters. Serum creatinine and IGF-1 concentrations as well as LBM(Cr) were also decreased in higher transporters. The mean CNI score was 8.1 +/- 4.9, with a range of 0-24. CNI was positively correlated with age, duration of peritoneal dialysis, incidence of peritonitis, CRP and dialytic protein loss, whereas it was inversely correlated with ultrafiltration volume, haemoglobin and NPNA. The CNI score was significantly higher in high transporters compared with low transporters (11.7 +/- 4.3 vs. 5.9 +/- 1.6, P < 0.01). There was also a significant correlation between D/P(Cr) and CNI (r = 0.29, P < 0.05). Multiple regression analysis revealed that the incidence of peritonitis, duration of CAPD, CRP and D/P(Cr) were the independent factors affecting the CNI. CONCLUSION: Peritoneal membrane transport characteristics correlate with the overall nutritional status of peritoneal dialysis patients assessed by the scoring system of the CNI, although it is associated with a different impact on the individual nutritional indices. The results of this cross-sectional study also suggest that a high permeability state is a risk factor for malnutrition in CAPD patients. Prospective studies evaluating the changes in nutritional parameters among patients with different membrane transport rates are needed to understand better the relationship of peritoneal membrane characteristics to the nutritional status of CAPD patients.     

Predictors of survival in anuric peritoneal dialysis patients

BACKGROUND: Residual glomerular filtration rate (GFR) is a much more important determinant of survival in peritoneal dialysis patients, than peritoneal solute clearances. However, anuric peritoneal dialysis patients are solely dependent on peritoneal solute clearances. The aim of the study was to analyze the effects of peritoneal small solute clearances and ultrafiltration on survival in anuric patients, and to establish the minimum levels of small solute clearances and net ultrafiltration. These objectives were investigated in a prospective cohort study in incident peritoneal dialysis patients who had become anuric during follow-up. METHODS: The Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD) is a prospective multicenter cohort study in which new adult dialysis patients are included and followed during 6 months intervals. Included were 542 peritoneal dialysis patients. Of these, 166 developed anuria, 130 of which could be included in the study. RESULTS: Two-year patient survival after the outset of anuria was 67%, technique survival 73%, and the combined 2-year patient and technique survival was 50%. Risk factors associated with mortality were age, comorbidity, the duration of peritoneal dialysis before anuria, and a low serum albumin. Peritoneal solute clearances were analyzed time-dependently. These parameters were not associated with survival when analyzed as continuous variables and also not when the analyses were done in quintiles, although the time-dependent approach was almost significant for Kt/V(urea). On the other hand, when the results were analyzed dichotomously using predefined cutoff points, Kt/V(urea) <1.5 per week and creatinine clearance <40 L/week/1.73 m2 were associated with an increase in the relative risk of death. Also peritoneal ultrafiltration was significantly associated with survival. CONCLUSION: The survival of anuric peritoneal dialysis patients is in line with expectations based on the duration of dialysis. The risk factors for death are the same as in the dialysis population as a whole. Besides an association with ultrafiltration, our study enabled us to define the lower limits of adequate peritoneal dialysis, that is Kt/V(urea) <1.5 per week and creatinine clearance <40 L/week/1.73 m2.     

Total lymphocyte count in peripheral blood of peritoneal dialysis patients: relationship to clinical parameters and outcome

BACKGROUND: Total lymphocyte count (TLC) is used as a nutritional status measurement. The impact of TLC on mortality in peritoneal dialysis (PD) patients is controversial. This study aimed at evaluating the effect of TLC on mortality, and assessing the relationship between TLC and nutritional status, anemia and erythropoietin (EPO) response, acute-phase response, dialysis adequacy and volume status in PD patients. METHODS: Seventy-three PD patients were monitored for 3 yrs from the beginning of the treatment. Data recorded for each patient included demographic features, comorbidity, TLC, blood biochemistry, systolic and diastolic blood pressures (BP), indices of dialysis adequacy and nutritional status, total fluid removal and mortality. Adjusted mortality risk for TLC was estimated using the Cox's regression models composed by TLC and one covariate having a value p<0.05 in univariate analysis. RESULTS: The 3-yr patient survival rates were significantly different among the TLC quartiles. The adjusted TLC was found, generally, to be a significant predictor of death in reduced Cox's models, except in models composed of TLC and total fluid removal or serum albumin. The receiver operating characteristics (ROC) analysis demonstrated that TLC provided a significant prediction of mortality. TLC correlated positively to total fluid removal, serum albumin, triglyceride and hematocrit, and negatively correlated to BP, high peritoneal transport and EPO-need. It did not correlate to other measures of nutritional status, dialysis adequacy and acute-phase response. Fluid removal and serum triglyceride were independent predictors of TLC in multivariate analysis. CONCLUSIONS: Our findings suggest that TLC can be used as a simple prognostic tool in PD patients; however, the association between TLC and mortality is confounded by other prognostic factors. Volume status could be a more important factor affecting the TLC than nutritional status.     

Risk factors for peritoneal dialysis withdrawal due to peritoneal dialysis-related peritonitis

BackgroundPeritoneal dialysis has become commonly used for renal replacement therapy; however, some patients withdraw from peritoneal dialysis due to complications, including peritoneal dialysis-related peritonitis, resulting in the low number of patients on peritoneal dialysis. Risk factors for peritoneal dialysis withdrawal due to peritoneal dialysis-related peritonitis are less certain. This retrospective study aimed to investigate these risk factors.MethodsWe retrospectively analyzed clinical characteristics, laboratory data, and causative microorganisms of 204 episodes of peritoneal dialysis-related peritonitis between 2007 and 2018 at our institution.ResultsOf the 204 episodes, 38 resulted in withdrawal from peritoneal dialysis due to peritoneal dialysis-related peritonitis. The number of peritonitis episodes per patient-year and the incidence of cardiovascular disease were significantly higher in the withdrawal group. Similarly, this group had low levels of serum creatinine, urea nitrogen, serum albumin, alanine aminotransferase, cholinesterase and high C-reactive protein, and second dialysate cell counts after antibiotic administration. Multivariate logistic regression analysis revealed that serum albumin (odds ratio: 0.465; 95% confidence interval: 0.249–0.868; P = 0.016) and cardiovascular disease (odds ratio: 2.508; 95% confidence interval: 1.184–5.315; P = 0.016) exhibited significant differences.ConclusionsThe results of this study suggest that hypoalbuminemia and the presence of cardiovascular disease were independent risk factors for withdrawal from peritoneal dialysis due to peritoneal dialysis-related peritonitis.     

Baseline hyponatremia does not predict two-year mortality in patients with chronic peritoneal dialysis

Purpose: Hyponatremia is a common electrolyte abnormality in a variety of medical conditions. Lower predialysis serum sodium concentration is associated with an increased risk of death in oligoanuric patients on hemodialysis. However, whether hyponatremia affects the short-term mortality in chronic peritoneal dialysis (CPD) patients remains unclear. Methods: We conducted a cross-sectional and two-year follow-up review retrospectively, and 318 patients with CPD were enrolled in a medical center. Serum sodium levels were measured at baseline and categorized as quartile of Na: quartile 1 (124–135?mEq/L), quartile 2 (136–139), quartile 3 (140–141) and quartile 4 (142–148). Mortality and cause of death were recorded for longitudinal analyses. Results: The patients with higher quartile (higher serum sodium) had a trend of lower age, peritoneal dialysis (PD) duration, co-morbidity index, D/P Cr and white blood cell counts and higher renal Kt/Vurea (Kt/V) and serum albumin level. Stepwise multiple linear regression analysis showed that serum sodium level was positively associated with albumin, residual renal Kt/V and negatively associated with age and PD duration in CPD patients. After two-year follow-up, stepwise multivariate Cox proportional hazards model demonstrated that age, co-morbidity index and serum albumin were the significant risk factors for all-cause two-year mortality, but not serum sodium levels. Conclusions: Serum sodium level in CPD patients is associated with nutritional status, residual renal function and duration of PD. However, baseline serum sodium level is not an independent predictor of two-year mortality in CPD patients.     

Peritoneal transport status and first episode of peritonitis: a large cohort study

BackgroundPeritonitis is one of the most serious complications of peritoneal dialysis (PD). This study aimed to explore the relationship between peritoneal transport status and the first episode of peritonitis, as well as the prognosis of patients undergoing continuous ambulatory peritoneal dialysis (CAPD).MethodA retrospective cohort study was conducted, analyzing data of CAPD patients from 1st January 2009, to 31st December 2017. Baseline data within 3 months after PD catheter placement was recorded. Cox multivariate regression analysis was performed to determine the risk factors for the first episode of peritonitis, technique failure and overall mortality.ResultsA total of 591 patients were included in our analysis, with a mean follow-up visit of 49 months (range: 27–75months). There were 174 (29.4%) patients who had experienced at least one episode of peritonitis. Multivariate Cox regression analysis revealed that a higher peritoneal transport status (high and high-average) (HR 1.872, 95%CI 1.349–2.599, p = 0.006) and hypoalbuminemia (HR 0.932,95% CI 0.896, 0.969, p = 0.004) were independent risk factors for the occurrence of the first episode of peritonitis. In addition, factors including gender (male) (HR 1.409, 95%CI 1.103, 1.800, p = 0.010), low serum albumin (HR 0.965, 95%CI 0.938, 0.993, p = 0.015) and the place of residence (rural) (HR 1.324, 95%CI 1.037, 1.691, p = 0.024) were independent predictors of technique failure. Furthermore, low serum albumin levels (HR 0.938, 95%CI 0.895, 0.984, p = 0.008) and age (>65years) (HR 1.059, 95%CI 1.042, 1.076, p < 0.001) were significantly associated with the risk of overall mortality of PD patients.ConclusionsBaseline hypoalbuminemia and a higher peritoneal transport status are risk factors for the first episode of peritonitis. Factors including male gender, hypoalbuminemia, and residing in rural areas are associated with technique failure, while hypoalbuminemia and age (>65years) are predictors of the overall mortality in PD patients. Nevertheless, the peritoneal transport status does not predict technique failure or overall mortality of PD patients.     

Associations of low serum total bilirubin level with all-cause mortality and cardiovascular mortality in peritoneal dialysis patients

Objective To investigate the association of low serum total bilirubin (TBIL) level with all-cause mortality and cardiovascular mortality in peritoneal dialysis patients. Methods As a single-center, retrospective, cohort study, all the patients who underwent peritoneal dialysis catheterization in the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University and started peritoneal dialysis for more than 3 months from January 1, 2006 to December 31, 2010 were included. Demographics, baseline clinical and laboratory test results were collected. All patients were followed up until December 31, 2012. Patients were divided into 4 groups according to their baseline serum TBIL levels (interquartile range). Kaplan-Meier method was used to compare the survival rate of each group. Cox regression model was used to analyze the association of TBIL with all-cause mortality and cardiovascular mortality. Logistic regression was used to analyze the influencing factors of low TBIL level. Results A total of 880 peritoneal dialysis patients with baseline TBIL data were enrolled in this study, with age of (48.0±15.4) years old, among whom 59.0% were male. Median TBIL was 4.5 μmol/L and interquartile range was 3.4-5.8 μmol/L. The comparison between TBIL quartile groups showed that the difference in proportion of diabetics, Charlson comorbidity index, hemoglobin, serum albumin, serum calcium, intact parathyroid hormone, urea nitrogen, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was statistically significant (all P＜0.05), while the difference in body mass index (BMI), estimated glomerular filtration rate, serum creatinine, urea nitrogen, uric acid and phosphorus was not statistically significant. After a median follow-up of 31 months, 194 patients died, 104 of which were cardiovascular deaths. Kaplan-Meier curves showed higher all-cause mortality in patients with TBIL≤3.4 μmol/L (Q1 group) (P=0.032) and there was no statistical difference in the cardiovascular mortality among different groups. After adjusting for biochemical indicators such as demographics, comorbidities, and liver function, taking baseline TBIL Q2 level (3.4＜TBIL≤4.5 μmol/L) as a reference, the hazard ratio for all-cause death in patients with TBIL≤3.4 μmol/L was 1.702 (95%CI 1.093-2.650, P=0.019), and the hazard ratio for cardiovascular death was 1.760 (95%CI 0.960-3.227, P=0.068). Multiple logistic regression analysis results showed that diabetes (OR=1.065, 95%CI 1.010-1.122, P=0.019) and high BMI (OR=1.838, 95%CI 1.056-3.197, P=0.031) were risk factors for baseline serum TBIL≤3.4 μmol/L. However, high hemoglobin (OR=0.990, 95%CI 0.982-0.998, P=0.011), high serum albumin (OR=0.950, 95%CI 0.916-0.985, P=0.006) and high ALT (OR=0.998, 95%CI 0.976-0.999, P=0.036) were the protective factors for patients with baseline serum TBIL≤3.4 μmol/L. Conclusion Baseline serum TBIL≤3.4 μmol/L in peritoneal dialysis patients is independently associated with all-cause mortality, and is not significantly associated with cardiovascular mortality; and baseline serum TBIL≤3.4 μmol/L occurred is associated with diabetes, high body mass index, low levels of hemoglobin, serum albumin and ALT.