Clinical Analysis And Comparison Of Different Dialysis Methods In Patients With End-stage Renal Disease

Objective:By comparing the clinical analysis of patients with ESRD treated by hemodialysis group(HD)and peritoneal dialysis group(PD),the patients with ESRD can obtain better efficacy,improve the quality of life and survival rate,and improve the prognosis.Methods:From January 2014 to March 2019,475 cases of ESRD patients who received the first dialysis treatment in the department of nephrology of the second hospital of jilin university were selected.According to the dialysis method,they were divided into HD group and PD group,among which 214 cases were in HD group and 261 cases were in PD group.All clinical data of patients before and after dialysis at 0.5,1,2,3,4 and5 years were recorded and analyzed,as well as factors affecting the prognosis of patients.Results:1.In this study,both HD and PD patients were more male than female,and the percentages of male and female in the HD group were 60.75% and 39.25%,respectively,and the percentages of male and female in the PD group were 59% and41%,respectively.The mean age of patients in the two groups was 53.5(45,64)years in the HD group and 54(41,62)years in the PD group.The primary diseases in the two groups were chronic glomerulonephritis,diabetic nephropathy,hypertensive kidney damage,etc.2.Total protein,albumin,alkaline phosphatase,potassium,phosphorus,magnesium and parathyroid hormone in the HD group were higher than those in the PD group(P<0.05);In PD group,leukocyte,LDL,total cholesterol,uric acid,cystatin C,carbon dioxide binding force and ionic calcium were higher than in HD group(P<0.05).The prevalence of hypertension and secondary hyperparathyroidism in HD group was higher than that in PD group(P<0.05);The prevalence of infection and malnutrition in PD group was higher than that in HD group(P<0.05).3.The survival rate during the follow-up period was 99.5% for 0.5 year,96.1% for 1year,93.3% for 2 years,85.5% for 3 years,82.1% for 4 years,69.2% for 5 years in the HD group,98.5% for 0.5 year,95.6% for 1 year,90% for 2 years,83.2% for 3years,79.9% for 4 years,and 67.9% for 5 years in the PD group,with no statistically significant difference.Age analysis showed that the survival rate of HD patients in ESRD dialysis patients ? 65 years old was higher than that of PD patients(P<0.05).COX multivariate analysis showed that age and transferrin were independent risk factors affecting the prognosis of ESRD hemodialysis patients.Age is an independent risk factor affecting the prognosis of ESRD pd patients,and albumin is a protective factor affecting the prognosis of ESRD pd patients.Conclusion:1.The HD group in the dialysis center was superior to the PD group in correcting lipid metabolism disorder,and the prevalence of malnutrition and infection was lower than the PD group.PD group was superior to HD group in correcting ion and PTH,and the prevalence of hypertension was lower than HD group.2.There was no statistically significant difference in survival rate between ESRD hemodialysis and peritoneal dialysis patients in this dialysis center at the follow-up visits of 0.5 years,1 year,2 years,3 years,4 years and 5 years.3.The survival rate of HD group of ESRD dialysis patients ?65 years old in this dialysis center was higher than that of PD group.4.Age and transferrin are independent risk factors affecting the prognosis of ESRD hemodialysis patients in this dialysis center.Age is an independent risk factor affecting the prognosis of ESRD pd patients,and albumin is a protective factor affecting the prognosis of ESRD pd patients.