Causes Of Death In Elderly Patients With Continuous Ambulatory Peritoneal Dialysis

[Objective]To investigate the causes of death and the risk factors in the elderly patients of PD.[Methods and materials]A total of 98 elderly patients (≥60 years old) with regular dialysis time≥3 months entered our CAPD program from September 2002 to September 2010. Among them, while 37 patients who died during the experiment were divided into the death group, while 61 survival patients as control group,. We choose the following parameters:age, sex, the prevalence of diabetes, time of dialysis, systolic blood pressure(SBP), diastolic blood pressure(DBP), Systolic pulmonary artery pressure (SPAP), hemoglobin(Hb), hematocrit(HCT), urea nitrogen(Urea), serum creatinine(Cre), serum calcium (Ca),phosphorus (P), serum ferritin(SF), parathyroid hormone(PTH),glucose(Glu), albumin (Alb), cholesterol(Chol), triglyceride(TG),high density lipoprotein cholestero(HDL-ch),low density lipoprotein cholesterobin(LDL-ch). Firstly, one way analysis was carried on to analyze the above parameter to find some significative index, and then the Mul-variabl non-conditional logistic regression analysis was used to analyze the correlation between the riskfactors and the death. Secondly, analyze the relationship between the SPAP, ALB and mortality. Thirdly, analysis of covariance was used to test the basic data of the diabetic patients and non-diabetic patients, and then theχ2 test was used to analyze the relationship between the diabetes and the mortality. All the patients were told to restrict water and salt,and accepted the same supportive treatments, such as control the blood Pressure or glucose to certain value, and the treatment of anemia, and so on.[Results](1)The top 3 primary disease of PD patients are Diabetic Nephlopathy (DN) 14 cases (37.84%), hypertensive nephropathy 8 cases (21.63%), chronic Glomerular Nephitis (CGN) 6 cases (16.22%). The following primary disease are Aristolochic Acid Nephropathy 4 cases (10.81%), Obstructive Nephropathy 2 case (5.4%), Polycystic Kidney Disease 2 case (5.4%), and else others (2.7%).(2)The cause of death in 37 cases PD Patients are cardiovascular disease 15 cases (40.54%), cerebral vascular accident (CVA) 7 cases (19%), severe infection 6 cases (16.22%),multiple organ dysfunction syndrome(MODS) 3 cases (8.11%), digestive tract hemorrhage 2 cases (5.4%), tumor 3 cases (8.11%), and else 1 (2.70%).(3)One way analysis of PD patients between death group and survival group shows that age, SBP,DBP,SPAP,the prevalence of diabetes,dialysis time,Hb,HCT,Glu,Alb, and HDL-ch, the total 11 variables have statistics difference (P<0.05). The mul-variabl non-conditional logistic regression analysis shows that Hb, Alb,and HDL-ch are protective factors for PD patients, while SBP,age,SPAP,and Glu are risk factors for MHD patents.(4)A11 the patients were divided into four interval groups according to SPAP. value, then analyzed the death rate of each group.There were positive correlationship between the SPAP and the death for PD patients.(5)The PD patients were divided into six interval paragraphs according to Alb value, then analyzed the death rate of every interval paragraph. There were negative correlationship between the Alb and the death for PD patients(6) There were statistic difference of the age, SBP,DBP, dialysis time, SPAP, Alb,Glu, and HDL-ch between diabetes and non-diabetes groups. And the death rate of diabetes group was 53.33%, while non-diabetes group with 30.88%, and thex2test between death and survival showed theχ2=8.432, P=0.012<0.05,there was Significant difference. [Conclusion]1. The main causes of death for PD patients are cardiovaseular accident, cerebral vascular accident,and severe infection.2. SPAP, SBP and Age are risk factors for PD patients, while Hb and Alb are protective factors for PD patients.3. There were positive correlationship between the SPAP and the death for PD patients, while negative correlationship between the Alb and the death.4.. Diabetes could increase the mortality of elderly PD patients.