| Objective:To analyze the clinical characteristics,cause of death,survival rate,technical survival rate and their affecting factors of maintenance peritoneal dialysis patients in our hospital,and to take positive and effective measures for various affecting factors to raise survival rate and technical survival rate and improve the prognosis of peritoneal dialysis patients.Methods:By retrospectively analysis the clinical data of 184 maintenance peritoneal dialysis patients between January 2012 and January 2016 in our hospital,including general indicators: sex,age,primary disease,24-hour urine volume and so on;Laboratory indicators: biochemical criterion,and hemoglobin(Hb),serum albumin(Alb),parathyroid hormone,serum ion(calcium,phosphorus)of first dialysis and dialysis in six months,1 year,2 years,3 years and 4 years.Dialysis related indicators: peritoneal equilibrium test,peritoneal dialysis related peritonitis,peritoneal dialysis correlation cardio-cerebrovascular disease,ultrafiltration volume,peritoneal dialysis outcome and the cause of death,and the like,to explore the peritoneal dialysis patients' clinical characteristics,therapeutic effect,the influence factors of survival rate and technical survival rate.Results: 1.The general situation:The average age of 184 peritoneal dialysis patients in our center was 53.3±15.3 years old,mostly distributed in 50-60 years,the average age of dialysis was 15.4±10.3 months,the ratio of male to female was 1:1.09.The primary disease in order was: chronic glomerular nephritis,diabetic nephropathy,hypertensive renal damage,kidney damage of tubulointerstitium and so on.The average of residual renal function was 4.15±2.78ml/min,peritoneal transport function was mainly high peritoneal transport rate(33.7%),the incidence of peritonitis was 28.26% and the proportion of peritonitis was high in April-May and October-December.20 patients(10.9%)died in 184 peritoneal dialysis cases by June 30,2016.The cause of death were: cardiovascular factors in 17 cases(85%),cerebrovascular factors in 2 cases(10%)and infection factors in 1 case(5%).2.Curative effect:There were 51.83% of the patients with hemoglobin level ?100g/L and 64.58% of the patients with albumin level?35g/L.After dialysis in half a year,1 year,2 years,3 years,4 years,there were 71.01%?72.50%?71.10%?87.50%?66.70% patients whose blood calcium was controlled,52.60%,54.40%,52.60%,75.00%,100.00% patients whose blood phosphorus was controlled,51.20%,49.30%,57.10%,75.00%,51.20% patients whose PTH was controlled.3.Survival analysis:1)By the life table analysis showed that peritoneal dialysis for 1 years,2 years and 4 years,the survival rates were 88.70%,84.10%,84.10% and the technical survival rate were: 79.90%,73.50%,64.30%;In general,the survival rate decreased with the extension of dialysis time.2)Kaplan-Meier univariate analysis showed that age,serum creatinine,blood uric acid of first dialysis affected the survival rate of peritoneal dialysis patients,The result of multivariate COX regression analysis showed that age and serum creatinine level were the independent factors for survival in patients with peritoneal dialysis.Age,24-hour urine output,serum creatinine and high transport type were the influence factors that affected technical survival rate,the multi-factors COX regression models showed that: age,24-hour urine output,high transport type were the independent factors of technical survival rate.Conclusion: 1.The most common primary disease of maintenance peritoneal dialysis patients in our center was chronic glomerulonephritis, followed by diabetic nephropathy.2.Cardiovascular event was the main cause of death for patients with peritoneal dialysis in our dialysis center.3.Age and serum creatinine level were independent risk factors for survival in patients,while age,24-hour urine volume and high transport type were independent risk factors for technical survival in patients. |
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