持续非卧床腹膜透析患者退出原因及预后分析

目的分析持续非卧床腹膜透析（CAPD）患者退出腹膜透析的原因，并探讨影响其预后的因素。方法调查2005年2月1日至2009年10月31日在本腹透中心进行CAPD的终末期肾病患者的临床资料，以Kaplan—Meier法及COX回归法分析影响患者死亡预后的因素。结果共105例入选本研究，退出腹膜透析25例，透析后1年内退出17例。退出患者中死亡19例、肾移植3例、转血液透析3例。死亡原因：心脑血管事件8例、因经济原因放弃治疗5例、感染3例、不明原因2例、腹膜炎1例。发生糖尿病及低血清白蛋白与患者的死亡相关（P〈0．05）。结论腹膜透析退出大多发生于透析后第1年，心血管事件是CAPD患者死亡的主要原因。发生糖尿病及血清白蛋白浓度下降是腹膜透析患者退出的危险因素。

Causes and prognosis of the dropout in patients with continuous ambulatory peritoneal dialysis

Objective To analyze the reason and affected factors associated with dropout of patients with continuous ambulatory peritoneal dialysis （CAPD）. Methods Between Feb. 2005 and Oct. 2009, 105 CAPD patients were recruited for analysis. The affected factors associated with dropout of patients with CAPD were also analyzed. Results A total of 105 patients were included in this study, of which 25 cases dropped out. 17 eases were dropped out within one year after initiation of CAPD. 19 cases died, 3 cases received renal transplantation, 3 cases were switched to hemodialysis. Diabetic patients （ P = 0.0002 ） and hypoproteinemia（ P = 0.001 ） had worse prognosis. Conclusion Cardioeerebral vascular event is the primary cause of death in CAPD patients. Diabetes mellitus and the decrease of albumin are the important affected factors of the dropout.