Comparison Of Efficacy And Prognosis Of Hemodialysis And Peritoneal Dialysis In Patients With End-stage Diabetic Nephropathy

Objective:Explore appropriate dialysis methods for patients with end-stage diabetic nephropathy to improve quality of life and prolong survival.Methods:Observing patients with end-stage diabetic nephropathy treated with dialysis in this study center,91 cases were peritoneal dialysis and 105 cases were hemodialysis.Basic data were recorded before dialysis.Record and analyze clinical data and complications before and after dialysis 0.5,1,2,and 3 years to understand the factors affecting patient survival.Results:1.There was no significant difference in age、gender、BMI、urine volumeand blood pressure before dialysis between the two groups.There was no statistically significant difference in clinical data such as renal function、nutritional status、glucose and lipid metabolism、ionic and parathyroid hormones、cardiac function index、hemoglobin and iron metabolism.There was no significant difference in the incidence of ischemic heart disease,cerebrovascular disease,severe infection,severe heart failure,anemia,and hyperparathyroidism.2.During the follow-up period,total cholesterol,triglyceride,urine volume,and serum creatinine were lower in the hemodialysis group than in the peritoneal dialysis group.Total protein,albumin,serum potassium,and parathyroid hormone were higher in the hemodialysis group than in the peritoneal dialysis group.The incidence of infection and heart failure in the peritoneal dialysis group was higher than that in the hemodialysis group.The incidence of hyperparathyroidism was higher in the hemodialysis group than in the peritoneal dialysis group.There was no significant difference in ischemic heart disease,cerebrovascular disease,and anemia between the two groups.3.The survival rates of the two groups during follow-up were hemodialysis group:0.5 year(97.1%),1 year(93.3%),2 years(88.5%),3 years(83.7%),and peritoneal dialysis group: 0.5 year(94.5%)One year(90.1%),two years(87.9%),and three years(84.6%)were not statistically significant.Analysis of age shows that the survival rate of patients under the age of 60 is greater than that of patients 60 years of age and older.Survival rate of hemodialysis patients in patients with end-stage diabetic nephropathy less than 60 years old and older than 60 years was not statistically different from that in peritoneal dialysis patients.COX multivariate analysis showed that age,ejection fraction,albumin,and serum ferritin were independent risk factors for the prognosis of patients with end-stage diabetic nephropathy.Age and albumin were independent risk factors for the prognosis of hemodialysis patients with end-stage diabetic nephropathy.And serum ferritin are independent risk factors for the prognosis of patients with end-stage diabetic nephropathy peritoneal dialysis.Conclusion:1.The dialysis center in patients with end-stage diabetic nephropathy hemodialysis patients with total cholesterol,triglycerides,urine output and serum creatinine were lower than peritoneal dialysis patients,and total protein,albumin,serum potassium,blood urea nitrogen and parathyroid hormone were higher than the peritoneum.2.There was no significant difference in survival rate between the end-stage diabetic nephropathy hemodialysis patients and peritoneal dialysis patients during follow-up.The survival rate of end-stage diabetic nephropathy dialysis patients below the age of 60 in this dialysis center is greater than that of patients 60 years of age and older.3.The dialysis center age、cardiac ejection fraction、albumin and serum ferritin were independent risk factors for the prognosis of patients with dialysis nephropathy in end-stage diabetes.4.The dialysis center age and albumin are independent risk factors influencing the prognosis of hemodialysis patients with end-stage diabetic nephropathy.5.The dialysis center age and serum ferritin are independent risk factors for prognosis of patients with peritoneal dialysis in end-stage diabetic nephropathy.