Analysis Of Risk Factors Of Cardiovascular Diseases And Prognosis In Peritoneal Dialysis Patients

Objective To investigate the incidence, risk factors of cardiovascular disease(CVD) and prognosis in end-stage renal disease(ESRD) patients on peritoneal dialysis(PD).Methods This study was performed from June 2009 to September 2015 in the peritoneal dialysis center of First Affiliated Hospital of Soochow University. Patients who had underwent peritoneal dialysis for over 3 months were enrolled and divided into two groups with and without CVD. The patients’ clinical data, including age, gender, primary disease, peritoneal dialysis age, blood tests and the mortality at the end of follow-up visit were recorded. The risk factors of CVD in PD patients were analyzed by the two variables Logistics regression. The camparation of survival time in two groups was analyzed by Kaplan-Meier analysis. the predictors for survival was analyzed by multivariable COX regression.Results Of all 159 PD patients, Chronic glomerulo nephritis(43.3%) was the most prevalent primary disease, followed by diabetic nephropathy(17.6%) and hypertensive nephropathy(17.0%), others were lupus nephritis(3.8%), systemic vasculitis(1.3%), polycystic kidney(1.3%), drug associated nephropathy(0.6%), obstructive nephropathy(0.6%) and unknown reasons(14.5%);(2)The incidence of cardiovascular disease was 47.8%. The levels of HB and ALB in group with CVD were significantly lower than those in group without CVD(P<0.01, P<0.01); The levels of Scr, TG and CRP in group with CVD were significantly higher than those in group without CVD(P<0.05, P<0.05, P<0.01); The Logistic analysis showed that ALB, TC, SCR, CRP were risk factors of CVD in PD patients.(3)Mortality in group with CVD was 21.1%, the group without CVD was 8.4%(P<0.05).(4)The main cause of death in PD patients was cardiovascular and cerebrovascular disease(51.3%);(5)The Kaplan-Meier analysis showed that the 1-, 2-, 3-year survival rates in group with CVD were 89.4%, 86.4%, 77.6% while in group without CVD were 98.0%, 95.3% and 86.3%,the survival rates in group with CVD were lower than group without CVD,P<0.05;(6)Univariate analysis showed the risk of death in patients with PD were the old age, high blood pressure and CVD complications. The multivariable COX regression analysis showed that age, CVD complications, triglyceride, CRP, decrease of H-LDL might be risk factors of death.Conclusion(1) Peritoneal dialysis patients had higher incidence of cardiovascular disease;(2) High levels of CRP, TG, SCR, and low level of ALB were risk factors in PD patients with CVD;(3) The main cause of death in PD patients are cardiovascular and cerebrovascular disease. The mortality of patients with CVD was significantly higher than those without CVD. The survival time of patients with CVD was lower than patients without CVD;(4) Age, CVD complications,triglyceride, CRP, H-LDL maight be the predictors for mortality of PD patients.