透析患者血浆Adiponectin水平和影响因素

目的观察维持性血液透析和腹膜透析患者血浆Adiponectin(ADPN)水平,探讨其相关影响因素.方法选择北京大学第三医院肾内科健康对照组20例,病情稳定的维持性血液透析患者30例,腹膜透析患者30例,ELISA方法测定3组研究对象的空腹血浆ADPN,每例透析患者测定血清白介素IL-6(IL-6)和肿瘤坏死因子(TNF-α),C反应蛋白,前白蛋白,转铁蛋白,血清甘油三酯,总胆固醇,计算KT/V,主观营养综合评估(SGA)透析患者的营养状况.结果①维持性腹膜透析患者血浆adiponectin水平较正常对照组明显升高(P=0.049),较血液透析组明显升高(P=0.007)[(2.335±1.673)mg/L Vs(1.442±0.632)mg/L Vs(1.256±0.613)mg/L],而血液透析组血浆ADPN水平较正常对照组差异无显著性(P＞0.05);②腹膜透析患者体重指数(BMI)≥25kg/m2较BMI＜25kg/m2其ADPN水平明显升高(P＜0.01),SGA评分营养良好者较营养不良ADPN水平明显升高(P＜0.01),多元回归分析ADPN的独立影响因素是BMI,回归方程为Y(ADPN)=-3.451 0.611X1(BMI);③Pearson相关分析表明血液透析患者ADPN水平与年龄负相关(r=-0.478,P=0.01),与透析充分性Kt/V正相关(r=0.518,P=0.016),与SGA评分负相关,但多元线性回归分析表明年龄、Kt/V是血液透析患者血浆ADPN水平的独立影响因素,其回归方程为Y(ADPN)=2.263-0.556X1(年龄) 0.403X2(Kt/V);④所有透析患者的血浆ADPN水平与超敏C反应蛋白,IL-6和TNF-α无显著相关,与血清甘油三酯,总胆固醇水平无显著相关.结论肾功能与透析治疗对血浆ADPN的水平调节只起很小的作用,腹膜透析患者的ADPN与体重指数正相关,血液透析患者的ADPN与年龄负相关,与透析充分性正相关.所有透析患者的营养水平与ADPN正相关,但不是独立影响因素,ADPN与透析患者炎症反应和血脂水平亦无明确相关性.     

Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

Background. Cardiovascular disease (CVD) is the major cause of mortality and morbidity of hemodialysis (HD) and peritoneal dialysis (CAPD) patients. We aimed to investigate the cardiovascular risk factors and their correlation with CVD in groups of HD and CAPD patients. Methods. Thirty HD patients, 30 CAPD patients and 30 healthy controls were included in the study. Apolipoprotein A‐l (apo A‐l), apolipoprotein B (apo B), apolipoprotein(a) [Lp(a)] and high‐sensitivity CRP (hs‐CRP) were measured with a Beckman Coulter nephelometer, and homocysteine (Hcy) was determined with an Agilent HPLC analyzer. Lipid profile was determined with a Synchron ^®LX 20 Pro analyzer. Results. Hcy levels were 41.9±19.4, 41.8±38.5 and 9.3±3.5?µmol/L; Lp(a) levels were 325±315, 431±367 and 130±97?mg/L; hs‐CRP levels were 3.78±3.21, 4.34±3.39 and 2.07±1.67?mg/L; apo A1/apo B ratios were 1.46±0.6, 1.36±0.5 and 1.80±0.59; total cholesterol levels were 3.56±0.7, 4.84±1.1 and 4.39±0.5?mmol/L; triglycerides were 1.44±0.5, 1.60±0.8 and 0.85±0.5?mmol/L in the HD, CAPD and control groups, respectively. Conclusion. HD and CAPD patients had higher Hcy, hs‐CRP and Lp(a) levels and lower apo A/B ratios than controls. There was no significant difference between the HD and CAPD groups. Hypertension, age and hs‐CRP showed a positive correlation with CVD.     

Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

BACKGROUND. Cardiovascular disease (CVD) is the major cause of mortality and morbidity of hemodialysis (HD) and peritoneal dialysis (CAPD) patients. We aimed to investigate the cardiovascular risk factors and their correlation with CVD in groups of HD and CAPD patients. METHODS. Thirty HD patients, 30 CAPD patients and 30 healthy controls were included in the study. Apolipoprotein A-l (apo A-l), apolipoprotein B (apo B), apolipoprotein(a) [Lp(a)] and high-sensitivity CRP (hs-CRP) were measured with a Beckman Coulter nephelometer, and homocysteine (Hcy) was determined with an Agilent HPLC analyzer. Lipid profile was determined with a Synchron LX 20 Pro analyzer. RESULTS. Hcy levels were 41.9+/-19.4, 41.8+/-38.5 and 9.3+/-3.5 micromol/L; Lp(a) levels were 325+/-315, 431+/-367 and 130+/-97 mg/L; hs-CRP levels were 3.78+/-3.21, 4.34+/-3.39 and 2.07+/-1.67 mg/L; apo A1/apo B ratios were 1.46+/-0.6, 1.36+/-0.5 and 1.80+/-0.59; total cholesterol levels were 3.56+/-0.7, 4.84+/-1.1 and 4.39+/-0.5 mmol/L; triglycerides were 1.44+/-0.5, 1.60+/-0.8 and 0.85+/-0.5 mmol/L in the HD, CAPD and control groups, respectively. CONCLUSION. HD and CAPD patients had higher Hcy, hs-CRP and Lp(a) levels and lower apo A/B ratios than controls. There was no significant difference between the HD and CAPD groups. Hypertension, age and hs-CRP showed a positive correlation with CVD.     

Procalcitonin levels in peritoneal dialysis patients.

OBJECTIVE: To examine whether the levels of procalcitonin (PCT), a new marker of infection and/or inflammation, differ between peritoneal dialysis (PD) patients and healthy volunteers, and whether PCT is detectable in uninfected drained dialysate. DESIGN: Observational cross-sectional study. SETTING: PD unit, department of medicine, in a university hospital. PATIENTS: A total of 28 PD patients, free of systemic infection, and 28 age- and sex-matched healthy volunteers. METHODS: PCT was determined by immunoluminometry; detection range 0.01 - 500 ng/mL, reference range < 0.5 ng/mL. RESULTS: Plasma levels of PCT were significantly higher (Wilcoxon's paired test, p < 0.001) in PD patients (median 0.33 ng/mL) compared with healthy volunteers (0.18 ng/mL). Spearman's test demonstrated a significant positive correlation between PCT and serum C-reactive protein (CRP) (r = 0.59, p < 0.01); correlations between PCT and transferrin, total weekly creatinine clearance (ClCr), and the renal components of ClCr and Kt/V urea were negative. PCT levels in dialysate (PCTd) were 0.07 ng/mL and correlated positively with plasma PCT, serum CRP, and dialysate fibrinogen levels. The dialysate-to-plasma ratio (D/P) of PCT was 0.2. Neither PCTd nor D/P PCT correlated with D/P creatinine at 4-hours of dwell. CONCLUSION: Compared with healthy volunteers, PD patients without overt signs of infection showed increased plasma PCT levels. Given the study design, it is impossible to determine to what extent the increase in plasma PCT is due to reduced elimination and to what extent it reflects the microinflammation of uremia. Based on the D/P PCT gradient, we assume that PCT transport is more likely to occur from the systemic circulation to the peritoneal cavity than vice versa.     

腹膜透析病人的护理风险因素及预防

[目的]探讨腹膜透析病人的护理风险因素及预防对策。[方法]回顾分析2002年3月—2012年4月诊治的495例腹膜透析病人的护理风险因素。[结果]发生腹膜透析相关性腹膜炎者178例,皮肤损害15例,跌倒7例,导管损坏3例,脱落10例,心脑血管突发事件33例。[结论]腹膜透析病人主要护理风险因素为感染、心脑血管突发事件、皮肤损害、导管损坏、脱落、跌倒,做好风险因素评估,加强医护人员、病人及家属的安全防范意识,可降低病人风险事件的发生,提高病人生活质量。     

Plasma aluminum levels in pediatric dialysis patients: comparison of hemodialysis and continuous ambulatory peritoneal dialysis

Accumulation of aluminum occurs in children with renal failure and can cause anemia, disabling osteodystrophy, and encephalopathy. Effects on bone mineralization are of particular concern in pediatric patients with growth potential. We measured plasma aluminum levels in 36 patients on continuous ambulatory peritoneal dialysis (CAPD) and 22 on hemodialysis under surveillance at a single pediatric center. The levels were above normal in 35 and 21 patients, respectively, and the values correlated with the oral dose of aluminum-containing phosphate-binding medications (r = 0.57; P less than 0.001). Younger and smaller children had higher plasma aluminum levels and also received larger doses of oral aluminum-containing compounds. Mean plasma aluminum levels (57.2 +/- 52.8 and 48.7 +/- 32.1 micrograms/liter, respectively) and the daily oral doses of elemental aluminum (47.3 +/- 37.6 and 39.2 +/- 26.7 mg/kg, respectively) were not statistically different in patients on CAPD and those on hemodialysis. Plasma aluminum levels did not correlate with estimated cumulative oral intake of aluminum, total duration of dialysis, serum calcium and phosphorus concentrations, N-terminal parathyroid hormone levels, or transfusion requirements. Retention of aluminum is common in children undergoing dialysis, correlates with the amount of aluminum administered orally, and results in similar elevations of plasma aluminum with CAPD and hemodialysis. Younger and smaller children are at increased risk for accumulation of aluminum. Alternative methods for control of serum phosphorus are needed in children with end-stage renal disease.     

Carotid atherosclerosis and cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

BACKGROUND: Cardiovascular diseases are important factors in mortality and morbidity of dialysis patients. Cardiovascular risk assessment is important in order to arrange the treatment strategies. The aim of the study was to investigate the relationship between carotid atherosclerosis and various CVD risk factors in dialysis patients. METHODS: 22 HD and 54 PD patients were included in the study. Carotid artery intima media thickness (IMT) and plaque score (PS) were obtained by B-mode ultrasonography for each participant. Uric acid, albumin, bilirubin, lipid profile, apolipoprotein A-l (apo A-l), apolipoprotein B (apo B), lipoprotein(a) [Lp(a)], high-sensitivity CRP (hs-CRP), homocysteine (Hcy), vitamin A, vitamin E, sialic acid (SA) and thiobarbituric acid-reactive substances (TBARS) were determined. The differences of the cardiovascular risk factors between the patients according to the treatment modality and the comparison of the risk factors as indicators of IMT and PS were investigated. RESULTS: There was no significant difference in IMT and PS between the two groups. SA, TBARS, hs-CRP, total, HDL- and LDL-cholesterol, white blood cell (WBC) and erythrocyte sedimentation rate (ESR) levels were significantly higher; albumin levels were significantly lower in PD group. In multiple regression analysis, only bilirubin for IMT and SA for PS were independent predictors. CONCLUSIONS: SA can be a superior marker to hs-CRP in PD patients; however, hs-CRP seems to be a more valuable marker than SA in HD patients according to the correlation analysis. This study provides information and opportunity for comparison of relatively new cardiovascular risk markers in hemodialysis and peritoneal dialysis patients using carotid atherosclerosis as an objective assessment criterion.     

Peritonitis-related mortality in patients undergoing chronic peritoneal dialysis.

Peritonitis is a well-known cause of mortality in peritoneal dialysis (PD) patients. We carried out a retrospective study to disclose the clinical spectrum and risk profile of peritonitis-related mortality. We analyzed 693 episodes of infectious peritonitis suffered by 565 patients (follow-up 1149 patient-years). Death was the final outcome in 41 cases (5.9% of episodes), peritonitis being directly implicated in 15.2% of the global mortality and 68.5% of the infectious mortality observed. In 41.5% of patients with peritonitis-related mortality, the immediate cause of death was a cardiovascular event. Highest mortality rates corresponded to fungal (27.5%), enteric (19.3%), and Staphylococcus aureus (15.2%) peritonitis. Multivariate analysis disclosed thatthe baseline risk of peritonitis-related mortality was significantly higher in female [relative risk (RR) 2.13, 95% confidence interval (CI) 1.24-4.09, p = 0.02], older (RR 1.10/year, CI 1.06-1.14, p < 0.0005), and malnourished patients (RR 2.51, CI 1.21-5.23, p = 0.01) with high serum C-reactive protein (s-CRP) levels (RR 4.04, CI 1.45-11.32, p = 0.008) and a low glomerular filtration rate (RR 0.75 per mL/minute, CI 0.64 -0.87, p < 0.0005). Analysis of risk after a single episode of peritonitis and/or subanalysis restricted to peritonitis caused by more aggressive micro-organisms disclosed that overall comorbidity [odds ratio (OR) 1.21, CI 1.05-1.71, p = 0.005], depression (OR 2.35, CI 1.14-4.84, p = 0.02), and time on PD at the time of the event (OR 1.02/month, CI 1.00-1.03, p = 0.02) were other predictors of mortality. In summary, the etiologic agent is a definite marker of peritonitis-related mortality but gender, age, residual renal function, inflammation (s-CRP), malnutrition, and depression are other significant correlates of this outcome. Most of these risk factors are common to cardiovascular and peritonitis-related mortality, which may explain the high incidence of cardiovascular event as the immediate cause of death in patients with peritonitis-related mortality.     

腹膜透析患者早期腹膜炎发生情况的调查研究

目的探讨腹膜透析患者发生早期腹膜炎的危险因素。方法纳入某三级甲等医院2009年6月1日—2017年2月28日243例新入院的腹膜透析患者,随访至2018年3月31日。采用多因素Logistic回归分析早期腹膜炎的危险因素,分析早期腹膜炎的诱因、转归及病原学数据。结果纳入早期腹膜炎患者74例,多因素Logistic回归结果显示,导管出口感染与早期腹膜炎呈显著相关(OR=2.635,95%CI=1.289～5.388,P=0.008),革兰阳性菌是常见的致病菌,发生11例(68.75%)感染。导致早期腹膜炎发生常见的诱因为操作不当[6例(8.1%)]、腹泻或便秘[6例(8.1%)]及呼吸道感染[6例(8.1%)]。早期腹膜炎治愈65例(87.8%),复发或再发6例(8.1%)。结论腹膜透析导管出口感染是早期腹膜炎的独立危险因素,常见的病原体为革兰阳性菌,操作不当、腹泻或便秘及呼吸道感染是早期腹膜炎的常见诱因。     

糖尿病腹膜透析患者的长期预后及死亡危险因素研究

目的本文探讨了糖尿病腹膜透析患者的长期预后,并进一步研究了影响糖尿病腹膜透析患者预后的独立危险因素。方法入选2000年1月1日至2009年12月31日期间在上海交通大学医学院附属仁济医院腹膜透析中心开始腹膜透析治疗的所有终末期肾脏病（end-stage renal disease,ESRD）患者。采用Kaplan-Meier法分析患者的生存率、技术生存率和无腹膜炎生存时间,Log-rank法进行显著性检验。采用Cox比例风险模型分析患者死亡的危险因素。结果共有598例患者入选本研究,其中糖尿病患者130例（21.7%）。与非糖尿病患者相比,糖尿病患者的年龄较大（63.7±13.3岁比52.9±17.0岁,P〈0.001）,合并心血管疾病（cardio vascular disease,CVD）的比例更高（31.0%比13.6%,P〈0.001）,血白蛋白（32.4±5.7g/L比35.1±5.3g/L,P〈0.001）和蛋白质分解率（normalized protein catabolic rate,nPCR）较低（0.87%±0.26%比0.96%±0.22%,P〈0.001）。糖尿病腹膜透析患者的1年、2年、3年和5年患者生存率分别为86.1%、73.5%、58.2%和50.9%,低于非糖尿病腹膜透析患者（Log rank25.40,P〈0.001）。分层分析显示在年龄〈65岁的患者中,糖尿病腹膜透析患者的生存率显著低于非糖尿病患者（Logrank13.36,P〈0.001）;年龄≥65岁的患者中,糖尿病与非糖尿病腹膜透析患者的生存率相似（Logrank0.723,P=0.395）。糖尿病腹膜透析患者的技术生存率和无腹膜炎生存时间均与非糖尿病腹膜透析患者相似（P〉0.05）。老龄（HR1.0595%CI1.00～1.08,P=0.019）,低血清白蛋白（HR0.9195%CI0.83～1.00,P=0.041）和CVD合并症（HR4.4995%CI1.94～10.41,P〈0.001）是影响糖尿病腹膜透析患者生存的独立危险因素。结论糖尿病腹膜透析患者的长期生存率低于非糖尿病患者,但技术生存率及无腹膜炎生存时间与非糖尿病患者相似,提示腹膜透析是糖尿病ESRD患者适用的替代治疗方法之一。老龄、低血清白蛋白和CVD合并症是影响糖尿病腹膜透析患者生存的独立危险因素。     

腹膜透析患者并发脑卒中危险因素的临床分析

目的 探讨腹膜透析患者脑卒中的危险因素.方法 回顾性分析2005年1月至2012年1月深圳市第二人民医院肾内科122例腹膜透析患者的临床资料.将患者分为2组：合并脑卒中的患者（A组,n=17）和无并发脑卒中的患者（B组,n=105）.统计腹膜透析患者脑卒中的发生率.观察并比较2组患者血清C反应蛋白（CRP）水平、同型半胱氨酸浓度、血清尿酸浓度的差异.分析年龄、腹膜透析龄、高血压、糖尿病、同型半胱氨酸浓度、CRP水平、血清尿酸浓度、血清N末端脑钠肽前体（BNP）等指标与腹膜透析患者发生脑卒中的相关性.结果 本组患者共发生脑卒17例,发生率为13.9％,其中男性13例（76.5％）,女性4例（23.5％）.60岁以上患者发生脑卒中者共11例（64.7％）,60及岁以下患者发生脑卒中为6例（35.3％）,A组患者平均年龄63.5±10.7岁,B组患者平均年龄52.7±14.9岁,A组患者年龄大于B组患者年龄,差异有统计学意义（K0.05）.血清CRP水平A组（30.1±21.7mg/1）高于B组（12.1±13.3mg/1）、血同型半胱氨酸浓度A组（19.6±4.8umol/1）高于B组（14.8±6.9umol/1）,差异有统计学意义（P＜0.05）.血清尿酸浓度A组（340.4±71.0umol/l）低于B组（418.4±119.1umol/1）,差异有统计学意义（p=户0.01）.多因素非条件Logistic回归分析显示高血压（P=0.026）,糖尿病（P-0.022）,CRP （P=0.001）,BNP（P=0.045）,血清同型半胱氨酸（P=0.017）均为腹膜透析患者发生脑卒中的危险因素.结论 本组腹膜透析患者脑卒中发生率为13.9％.高血压、糖尿病、高CRP浓度、高同型半胱氨酸浓度均是腹膜透析患者发生脑卒中的独立危险因素.     

Cefotaxime and metabolite disposition in two pediatric continuous ambulatory peritoneal dialysis patients.

OBJECTIVE: To characterize the pharmacokinetics of cefotaxime and desacetylcefotaxime in pediatric patients undergoing continuous ambulatory peritoneal dialysis (CAPD) after intraperitoneal administration of cefotaxime. DESIGN: Case series. SETTING: Ambulatory children from Children's Hospital nephrology clinic, Columbus, Ohio. PATIENT POPULATION: Two adolescents without peritonitis. METHODS: A single intraperitoneal dose of cefotaxime 500 mg per 1 L dianeal was given during CAPD. Cefotaxime and desacetyl-cefotaxime were measured in plasma, urine, and dialysate by HPLC. RESULTS: Maximum plasma concentration (Cmax) of cefotaxime was 11.94 and 13.08 mg/L and that of desacetylcefotaxime 5.73 and 5.33 mg/L. Time to reach maximum concentration (Tmax) of cefotaxime was 2.22 and 4.08 h, and that of desacetylcefotaxime was 5.33 and 5.73 h after instillation of the intraperitoneal cefotaxime dose. Systemic absorption of cefotaxime was 56.6 and 64.8 percent. Total clearance of cefotaxime was 62 and 79 mL/min/1.73 m2. Nonrenal clearance accounted for nearly 95 percent; renal and CAPD clearance contributed approximately 5 percent of the total clearance. Renal and CAPD clearance measurements of desacetylcefotaxime were similar to those for cefotaxime. Cefotaxime half-life was 1.83 and 2.49 h and desacetylcefotaxime half-life was 8.14 and 11.0 h. CONCLUSIONS: Cefotaxime was well absorbed and therapeutic serum concentrations were achieved after intraperitoneal administration. Renal and CAPD clearances for cefotaxime and desacetylcefotaxime were low. Cefotaxime nonrenal clearance was unaffected. Further studies are needed to establish appropriate intraperitoneal dosing guidelines of cefotaxime in pediatric CAPD patients.     

腹膜透析患者的转归及其危险因素分析

目的分析单中心27年间所有维持性腹膜透析患者的转归,探寻腹膜透析患者死亡的危险因素,讨论减少腹膜透析患者退出的策略。方法回顾性观察解放军第四五五医院自1985年1月开展第1例腹膜透析以来至2011年12月间所有行腹膜透析管置入术开始腹膜透析的患者,并除外维持性腹膜透析不足1月者。记录患者的转归及退出腹膜透析的原因,分析他们的人口学资料、实验室数据、透析充分性、残余肾功能、腹膜转运特性、营养状况等。结果共841例腹膜透析患者入选本研究,其中女性431例(51.2%)。开始腹膜透析时的平均年龄为58.53±16.67岁。原发病中慢性肾小球肾炎占第1位,为441例(52.4%),其次为高血压肾损害149例(17.7%),糖尿病肾病121例(14.4%)。患者的平均腹膜透析龄为18.63±20.35月。至2011年12月底,继续腹膜透析246例(29.2%),死亡296例(35.2%),转血液透析152例(18.1%),肾移植64例(7.6%),失访83例(9.9%)。心血管事件是首位死亡原因(41.6%);其次为感染(33.0%),包括肺部感染(23.2%)和腹膜炎(9.8%);第3位死亡原因是脑血管事件(9.5%)。转血液透析的最主要原因为腹膜透析相关感染(59.2%);然后是导管功能障碍(堵管、漂管等,25.7%);透析不充分(7.2%)。经COX回归模型分析提示,死亡的危险因素是老龄(HR:1.06,P<0.01);糖尿病(HR:1.88,P<0.01);血液透析转至腹膜透析(HR:1.49,P<0.01);低白蛋白血症(HR:2.44,P<0.01);血C反应蛋白增高(HR:2.07,P<0.01);低肌酐清除率(HR:1.89,P<0.05);腹膜高转运状态(HR:2.28,P<0.01)。结论在我中心,腹膜透析患者退出的最主要原因是死亡,其次是转至血液透析。心血管事件是第1位的死亡原因,腹膜透析相关感染是转血液透析的最主要原因。老龄、糖尿病、由血液透析转至腹膜透析、营养不良、炎症状态、透析不充分、腹膜高转运状态者有着更高的死亡风险。     

持续性非卧床腹膜透析患者腹膜炎发生的危险因素分析

目的探讨非卧床腹膜透析患者腹膜炎发生的危险因素。方法选取我院2017年1月至2018年12月收治的慢性肾衰竭持续性非卧床腹膜透析患者260例作为研究对象,采用一般情况调查问卷收集患者信息,统计记录腹膜炎发生情况,采用多因素logistic回归分析确定腹膜炎发生的影响因素。结果 260例患者中发生腹膜炎的73例,占28. 08%;多因素logistic回归分析显示腹膜炎发生的独立危险因素有高龄、低文化水平、合并糖尿病、透析时长、总蛋白(TP)水平下降、血钙(Ca)水平下降。结论我院慢性肾衰竭持续性非卧床腹膜透析患者相关性腹膜炎发生率为28. 08%,腹膜炎发生独立危险因素为高龄、低文化水平、伴有糖尿病、透析时间长、总蛋白水平下降、血钙水平下降,结合危险因素制定防范干预措施非常重要。     

Quality of life in chronic haemodialysis and peritoneal dialysis patients in Turkey and related factors

Turkey is the fifth country in Europe with regard to the number of patients receiving haemodialysis (HD). However, only a limited number of studies have comparatively investigated the factors that affect quality of life in haemodialysis and peritoneal dialysis (PD) patients in Turkey. The purpose of the study was to investigate the factors that affect quality of life in haemodialysis and peritoneal dialysis patients, as well as providing a comparison of quality of life between these groups. In this cross‐sectional study, Quality of Life Scale and a data form was completed by 300 dialysis patients who received treatment at five hospital‐based dialysis units in Istanbul, Turkey. The data were evaluated using arithmetic mean values, standard deviations, minimums, maximums, percentages, independent groups t‐tests, Spearman correlation analyses and one‐way variance analyses. The quality of life values in peritoneal dialysis patients were found to be higher than those of haemodialysis patients (P < 0.05). It was concluded that the quality of life in chronic dialysis patients was affected by various factors.     

腹膜透析患者死亡危险因素分析

目的探讨影响腹膜透析患者死亡的危险因素.方法回顾性分析2005年1月1日至2015年12月31日在广西医科大学第一附属医院肾内科腹膜透析中心置管且规律透析大于3个月的275例腹膜透析患者的临床资料.死亡的60例为观察组,继续规律腹膜透析的215例为对照组.采用单因素及二分类Logistic回归方法分析各临床指标对患者预后的影响.结果死亡组与对照组原发病为糖尿病肾病的构成比分别为15.0%(9/60)与5.6%(12/215),进入腹膜透析治疗时年龄分别为(50.6±14.3)岁与(45.7±13.2)岁(t=-2.518),肾小球滤过率分别为6.0(4.5,9.4)与5.1 (4.2,6.6),血钾分别为(4.2±0.7)mmol/L 与(4.5±0.7)mmol/L(t=2.14),血肌酐分别为721.0(585.0,891.3)μmol/L与847.0(723.3,1033.3)μmol/L,两组间差异均有统计学意义(P均<0.05).Logistic回归分析提示原发病为糖尿病肾病、进入腹膜透析治疗时年龄、肾小球滤过率、血尿酸是腹膜透析患者死亡的危险因素.结论糖尿病肾病、年龄、肾小球滤过率、血尿酸水平是影响腹膜透析患者死亡的独立危险因素.