腹膜透析患者退出因素分析

目的 寻找终末期肾衰竭患者退出腹膜透析(peritoneal dialysis,PD)的高危因素,为提高腹膜透析患者技术生存率提供依据.方法 以2008年1月至2013年12月本院腹膜透析患者共计196例为研究对象,分为退出组和对照组.退出腹膜透析患者为退出组,未退出腹膜透析患者为对照组.回顾性分析患者的社会状况、一般资料、临床资料等相关指标,如换液操作者、工作状态、残余尿量、血肌酐水平等,应用单因素、多因素Logistic回归分析进行统计学分析.结果 退出组共纳入54例,对照组共纳入142例,退出率为27.6％.单因素分析得出,腹透患者的居住地、文化程度、工作状态、换液操作者、残余尿量、血肌酐及eGFR水平对患者的退出有影响;多因素Logistic分析提示工作状态、换液操作者、残余尿量、血肌酐水平是患者退出的高危因素;其中,残余尿量与退出风险呈负相关,血肌酐水平与退出风险呈正相关.结论 本院PD患者退出率高的原因主要与患者开始行PD的时间太晚,残余肾功能较差有关.应加强患者教育,适时开始PD,鼓励患者参加工作,本人进行换液操作.

Analysis of risk factors about patient withdrew from peritoneal dialysis

Objective To investigate the risk factors for the dropout of peritoneal dialysis (PD),and then provide the foundation for improving survival rate of patients with end-stage renal failure.Methods Clinical data was collected from 196 PD patients in our hospital between January 2008 and December 2013.All patients were divided into two groups,dropout group and control group.The social condition,general information,clinical data and so on were collected.For example,the people who changed the extraneal,working condition,residual urine volume,as well as serum creatine were recorded.Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors for dropout.Results Univariate analysis showed that the place of residence,education level,working condition,people who changed the extraneal,residual urine volume,serum creatine,and eGFR impacted on the dropout.Multivariate logistic regression showed that working condtion,people who changed the extraneal,residual urine volume and serum creatine were independent factors.Residual urine volume was negatively correlated with dropout and serum creatine was positively correlated.Conclusions In our hospital,the main reason of the dropout of PD is the weaker residual urine volume.We should pay attention to patient education,find the appropriate timing to start PD,and encourage patients to take part in the work as well as change the extraneal by themselves.