Demographics And Prognostic Factors Of Peritoneal Dialysis Patients In Zhejiang Province

Part Ⅰ Demographics of Peritoneal Dialysis Patients in Zhejiang ProvinceObjectiveZhejiang Dialysis Quality and Management Center (ZDQM) registers information of peritoneal dialysis (PD) patients, includes demographic information, clinical data, outcomes, and laboratory data and so on. Our aim was to analyze the data of patients from 2008 to 2015, and to explore the demographics of PD patients in Zhejiang province.MethodsWe retrospectively review all PD patients registered in the ZDQM until December 31st,2015. The basic information, including birthday, gender, the first time of PD, outcomes, outcome reasons and time were collected. The incidence rate and prevalence rate of PD patients, structure of sex and gender, primary causes, the period of PD, and cause of mortality were investigated.Results9145 PD patients were included from 2008 to 2015. The prevalence rate of PD increased from 14.16 per million population (PMP) to 106.52PMP. The average age increased from 49.94 years old (2009) to 54.10 years old (2015); the most patients were 45 to 65 years old; the proportion of patients over 65 years old increased from 22.4%to 27.3%. Male were more than female. The period of PD increased from 1.63 years to 2.73 years, and the proportion of the patients who were more than 4 years increased from 6.1% to 23.0%. The first three primary causes of PD were chronic glomerulonephritis (61.5%), diabetic nephropathy (12.8%) and hypertensive nephrosclerosis (8.8%).35.48% of the PD patients dropped out,8.9% of them changed the renal replacement therapy to hemodialysis and 6.5% to renal transplantation,11.0% were died. In PD patients, the cardiac-cerebral vascular disease mortality (30.5%) was the leading cause of death, the next was infections (10.8%) and cancer (5.4%). The number of the patients who changed the renal replacement therapy to renal transplantation increased from 23 (2008) to 124 (2014).ConclusionIn Zhejiang province from 2008-2015, the prevalence rate of PD rises annually, average age for them is gradually growing, and the proportion of elderly patients is increasing, the period of PD is also increasing. The leading cause of ESRD is chronic glomerulonephritis. Cardiac-cerebral vascular disease mortality is the leading causes of mortality. The number of the patients who changed the renal replacement therapy to renal transplantation is also increasing.Part Ⅱ Prognostic Factors of Peritoneal Dialysis Patients in Zhejiang ProvinceObjectiveThe risk of death in peritoneal dialysis (PD) patients is higher than general population. Our aim was to analyze the demographic information, clinical and laboratory data of patients from 2008 to 2015, and to explore the prognostic factors of patient survival and technique survival of PD patients in Zhejiang province.MethodsWe retrospectively review all PD patients registered in the ZDQM until December 31st,2015. All patients were>18 years old and dialysis vintage>90 days, the beginning time of PD and outcomes were clear, clinical and baseline laboratory data were complete. Using the Kaplan-Meier survival curves, Log-Rank test and univariate Cox for univariate survival analysis, screened significant factors reintroduction Cox multivariate survival analysis. Found an independent risk factor for patient survival and technique survival.ResultsIn this study patients of Zhejiang Province, patient survival at 1,3, and 5 years was 96.0%,87.3%, and 80.3% respectively, technique survival was 96.5%,87.2%, and 73.3%. Multivariate survival analysis showed that the history of cancer (adjusted HR4.875; 95%CI,1.530-15.537, P=0.007), the age at the beginning time>65 years old (adjusted HR 2.807; 95%CI,1.823-4.322, P<0.001), C-response protein>4mg/L (adjusted HR 1.984; 95%CI,1.280-3.076, P=0.002) and serum albumin>35g/L (adjusted HR 0.454,95%CI,0.271-0.763, P=0.003), were independent prognostic factors for patient survival. Catheter-related complications (adjusted HR 4.674; 95%CI, 1.708-12.789, P=0.003), serum ferritin (adjusted HR 1.673; 95%CI,1.097-2.549, P=0.017) and female gender (adjusted HR 0.612; 95%CI,0.402-0.931, P=0.022) were independent prognostic factors for technique survival.Conclusion:The history of cancer, elderly, and high C-response protein were independent risk factors for patient survival, and high serum albumin was protective. Catheter-related complications and high serum ferritin were independent risk factors for technique survival, and female gender was protective.