| Objective To compare the survival rates of patients with primary diabetic kidney disease and non-diabetic kidney disease in maintenance hemodialysis.Methods The eligible patients who started hemodialysis treatment in our hospital from January 1,2010 to December 31,2016 were selected.The observed endpoint was all-cause death.Patients’gender,age at the start of dialysis and primary disease were recorded.The patients were divided into two groups according to the primary disease:group 1:diabetic kidney disease;group 2:non-diabetic kidney disease.The survival time was defined as the time from the start of dialysis to the death.The deleted value was defined as the time of patients who were still alive or lost to follow-up by December 31,2016,and the record unit was month.Routine data of the enrolled patients at the time of admission were collected,including gender,age of initiation of dialysis,date of initiation of dialysis,age of dialysis,death,time of death,cause of death and other information.Laboratory examination indexes before dialysis were collected,including hemoglobin,albumin,urea nitrogen,creatinine,cystatin C,blood lipid,uric acid,ion,PTH,ferritin,etc.In addition,data of complications were collected,including heart failure,coronary heart disease,hypertension,diabetes,stroke,tumor,etc.SPSS 13.0software was used for statistical analysis.Measurement data were expressed as mean standard deviation,and counting data were expressed as percentage.For comparison of numerical variables,t test is used for normal distribution,and U test is used for non-normal distribution.The chi-square test was used to compare the counting data.K-M survival analysis was used for survival analysis.Univariate COX regression analysis was used for risk assessment.Independent analysis was performed by multivariate COX regression.P<0.05 indicated that the difference was statistically significant.Results A total of 769 patients were enrolled,including 305 patients with primary diabetic kidney disease(39.7%)and 464 patients with non-diabetic kidney disease (60.3%).There were 465 males,accounting for 60.5%,and 304 females,accounting for39.5%.The mean age of starting dialysis was(56.2±14.9)years.The median follow-up time was 21 months.170 patients died due to all causes,accounting for 21.7%.The 1-,2-,3-,4-,5-,6-and 7-survival rates in the diabetic kidney disease group were 94%,77%,68%,56%,44%,31%and 26%.The 1-,2-,3-,4-,5-,6-and 7-survival rates in the non-diabetic kidney disease group were 94%,87%,81%,77%,69%,65%and 60%.The survival rate of the diabetic kidney disease group was significantly lower than that of the non-diabetic kidney disease group.The K-M analysis showed that the survival rate of the two groups was statistically significant(x~2=23.656,P<0.001).Univariate COX regression analysis the factors of influence on death,found that started dialysis age,primary disease,albumin,urea nitrogen,creatinine,cystatin C,MDRD-GFR,total cholesterol,low density lipoprotein cholesterol(LDL),high-density lipoprotein cholesterol(HDL),blood potassium,calcium,phosphorus,PTH,initial line of CRRT treatment,EF value,merging,heart failure,coronary heart disease,stroke,hypertension,diabetes had statistical significance(P<0.05).Multivariate Cox regression analysis showed that age at onset of dialysis,primary morbidity,low density lipoprotein,serum potassium,EF value,coronary heart disease,and stroke were independent risk factor of mortality(P<0.05).Conclusion The survival rate of patients with primary diabetic kidney disease was lower than those with non-diabetic kidney disease in the maintenance hemodialysis patients in our center,and the difference was statistical significant(P<0.001).Age at initiation of dialysis,primary disease of ESRD,low density lipoprotein,serum potassium,EF value,coronary heart disease,and stroke were independent predictors of death(P<0.05). |
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