The Survival And Outcome Analysis Of 237 Cases Of Peritoneal Dialysis Patients Of Single Center

Objective:To analyze the peritoneal dialysis patients who were in the peritoneal dialysis center of the First Affiliated Hospital of Soochow University, in order to realize the condition of outcome, technique survival rate,survival rate and influence factors of survival. According to the results of this study, we can take effective actions to prolong the period of dialysis and improve prognosis of peritoneal dialysis patients.Methods:A retrospective analysis of 237 cases of patients in our peritoneal dialysis center of the First Affiliated Hospital of Soochow University from December 1, 2007 to September 30, 2015, following-up more than three months. We analyzed the condition of outcome, technique survival rate, survival rate and influence factors of survival. We used statistical method of Kaplan-Meier to measure survival rate and technique survival rate. We also calculated hazard ratio for patient mortality using multivariate COX regression model to further clear the independent risk factors of affecting prognosis.Results:In the 237 cases of peritoneal dialysis patients, including 137 males(57.8%) and 100 females(42.2%), average age of 48.07?13.75 years. The primary diseases which lead to end-stage renal disease were chronic glomerulonephritis 174 cases(73.4%), diabetic nephropathy 27cases(11.4%), hypertensive renal impairment 22 cases(9.4%), nephritis of Schonlein-Henoch purpura 3 cases(1.3%), polycystic kidney disease 2 cases(0.8%), lupus nephritis, gouty nephropathy, obstructive nephropathy, interstitial nephritis each account for 1 case(0.4%) and unknown reason 5 cases(2.1%). Chronic glomerulonephritis was the most important primary disease. A total of 237 cases peritoneal dialysis patients, the average duration of dialysis was 29.78?23.50 months, during the dialysis, patients who died in 28 cases(11.8%), treated with kidney transplant in 19 cases(8.0%), turned to hemodialysis in 33 cases(13.9%), combined with hemodialysis in 4 cases(1.8%), lost for follow-up in 11 cases(4.6%) and remained on peritoneal dialysis in 142 cases(59.9%). The reasons of drop-out of peritoneal dialysis including deadth, treated with kidney transplant, changed to hemodialysis, combined with hemodialysis, and lost for follow-up. There were 95 cases patients drop-out of peritoneal dialysis, the total drop-out rate was 40.1%. The patients who drop-out of peritoneal dialysis including 55 males, the proportion of it takes the total drop-out patients was 57.9%, there was no statistically significant difference in the aspect of drop-out rates between males and females(P=0.982). A total of 28 cases of patients died, including 6 males and 22 females, the overall mortality rate was 11.8%, there was a statistically significant difference in the aspect of mortality rates between males and females(P<0.001). The causes of death included cardiovascular disease 10 cases(35.8%), cerebrovascular disease 5 cases(17.9%), infection 5 cases(17.9%), gastrointestinal bleeding 2 cases(7.1%), malignant tumor 2 cases(7.1%), malnutrition 2 cases(7.1%) and unknown reason 2 cases(7.1%). The 1, 3 and 5 years of patient survival rates were 96.5%, 85.2% and 76.9%, respectively. While the 1, 3 and 5 years of technique survival rates were 90.6%, 75.8% and 61.9%, respectively. The independent risk factors that influence the survival of peritoneal dialysis patients included the age, levels of serum uric acid, levels of serum phosphorus before peritoneal dialysis, as well as peritoneal transport characteristics and gender.Conclusion: The primary disease that lead to end-stage renal disease was chronic glomerulonephritis. The main reasons that drop-out from peritoneal dialysis were changed to hemodialysis and death. Cardiac-cerebral vascular disease and infection were the major causes that lead to death of peritoneal dialysis patients. In our peritoneal dialysis center, the rates of patient survival and technique survival were similarly equals to the developed countries and areas. Older age, higher serum uric acid, higher serum phosphorus and high peritoneal transport characteristics were the independent risk factors that influence the survival of peritoneal dialysis patients.