| Background:Chronic kidney disease(CKD)is the common outcome of various kidney diseases.At present,the internationally accepted definition of CKD is that if the renal function is damaged for more than 3 months,the abnormal structure or function of the kidney which has an impact on the health.Once it is formed,it usually progresses at different speeds until the end stage of renal failure.Epidemiological investigation showed that the prevalence of CKD in Chinese adults was 10.8%,and the prevalence of CKD was estimated to be 120 million.However,the awareness rate of CKD patients was only 12.5%,so the number of patients with chronic renal failure(CRF)increased rapidly.More and more CRF patients need kidney replacement therapy to maintain their lives.At present,there are three main types of renal replacement therapy:hemodialysis,peritoneal dialysis and renal transplantation.However,due to the constraints of renal supply,post-transplant complications and long-term oral immunosuppressive agents,most CRF patients rely on HD and PD for survival.Although HD technique was earlier than PD,PD was accepted gradually by CRF patients because of its simple equipment,less hemodynamic effect,better protection of residual renal function,flexible dialysis time and lower cost.Although PD technology has its limitations in recent years,how to improve the survival rate of PD patients is a clinical problem.In order to understand the survival rate of patients with peritoneal dialysis and its influencing factors,the related factors were analyzed retrospectively in order to take effective measures to improve the quality of life and reduce the mortality of patients with long-term peritoneal dialysis.In order to better guide the clinical treatment.Objective:A retrospective study was conducted on 968 patients with maintenance peritoneal dialysis in the peritoneal dialysis center of Department of Nephrology,firstaffiliated Hospital of Nanchang University,to explore the survival rate and prognostic factors of these patients.In order to improve the quality of life and prognosis of peritoneal dialysis patients,we can take effective measures in clinical treatment against these prognostic factors.Method:(1)A retrospective analysis of 1054 patients who were admitted to our hospital from November 2005 to May 2017 and underwent peritoneal dialysis catheterization in our hospital for long-term maintenance peritoneal dialysis,followed up for more than 3 months,excluded 42 cases of external catheterization and 8 cases of hemodialysis converted to abdominal dialysis.There were 2 cases of renal transplantation,3 cases of age less than 18 years old,1 case of repeated information,21 cases of peritoneal dialysis less than 3 months,9 cases of absence of baseline value,and 968 cases of abdominal dialysis were included.(2)Sex,age,primary cause,residual renal function,hemoglobin,serum albumin,serum phosphorus,serum calcium,cardiovascular and cerebrovascular events,triglyceride,complications and prognosis were recorded in 968 patients.The effect of single factor on the survival rate was analyzed by statistical Kaplan-Meier,and the effect of multiple factors on the survival rate was analyzed by Cox regression.Results:(1)From November 2005 to May 2017,among the 968 cases of peritoneal dialysis in our department,550 cases were male(56.2%),418 cases were female(43.8%).Primary basic kidney diseases with peritoneal dialysis leading to chronic renal failure include:627 cases of chronic glomerulonephritis,158 cases of diabetic nephropathy,119 cases of hypertensive renal damage,30 cases of obstructive nephropathy,16 cases of polycystic kidney disease,7 cases of Rhizoma lupus nephritis,5 cases of lupus nephritis,4 cases of hereditary and congenital diseases,1case of drug-induced toxic nephropathy,1 case of renal tubulointerstitial disease and 1case of tubulointerstitial disease.(2)As of May 31,2017,at the end of follow-up in this clinical study,there were227 deaths in 968 patients with peritoneal dialysis,including 129 deaths in men and98 deaths in women.CVD events were the leading cause of death in peritoneal dialysis patients,there were 120 cases of death(53.0%).There were 12 cases of extubation,151 cases of hemodialysis,57 cases of renal transplantation,6 cases of transfer to other peritoneal dialysis center,and 25 cases of missing visit.The 1-year?5-year and 8-year survival rates of peritoneal dialysis patients in this clinical study were 93%?76%?61%?15.5%?Univariate analysis of various factors by using Kaplan-Meier method showed that the factors affecting survival rate of peritoneal dialysis patients included age,serum phosphorus level and CVD history before dialysis.Multivariate Cox regression analysis showed that old age was an independent risk factor for the prognosis of peritoneal dialysis patients.Conclusion:Chronic glomerulonephritis is still the main cause of chronic renal failure in China.The survival rate of maintenance peritoneal dialysis patients decreased with the prolongation of dialysis age.The prognostic facts of long-term malntenance perltoneal dilalysis patients were age,blood phosphorus value,systolic blood pressure.Age at first dialysis was an independent risk factor for the prognosis of peritoneal dialysis patients.Cardiovascular events are the leading cause of death in maintenance peritoneal dialysis patients. |
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