Analysis Of Outcomes And Risk Factors Of Peritoneal Dialysis Patients

Objective:To analyze the clinical data of peritoneal dialysis(PD)patients in the Second Hospital of Shanxi Medical University,and to explore the outcomes of patients with PD and the risk factors.Methods:The basic clinical data of patients with long-term maintenance peritoneal dialysis from 2009-01 to 2019-06 in the Second Hospital of Shanxi Medical University were collected by retrospective study.Record the sex,age,primary disease,laboratory data and outcome of the patients.The outcome of the patients can be divided into: continuous peritoneal dialysis,withdrawal from peritoneal dialysis,and the reasons for withdrawal from peritoneal dialysis can be divided into: death,conversion to hemodialysis,kidney transplantation,recovery of renal function,and loss of visit.Spss20.0statistical software was used for data processing,and the measurement data was expressed as mean ± standard deviation,and the mean t test of two samples was used for group comparison.The counting data were expressed as percentage,and chi square test was used for comparison between groups.Chi square test and logrank test were used for single factor analysis(test level ?was 0.05),multivariate stepwise Cox regression model was used for multi factor analysis,setting ? in = 0.05,? out = 0.10,calculating hazard ratio(HR),and analyzing the risk factors of adverse outcome in patients who quit peritoneal dialysis.The difference was statistically significant(P < 0.05).Results:In 258 patients with maintenance peritoneal dialysis,chronic glomerulonephritis accounted for 42.2%,diabetic nephropathy 32.9%;97patients with withdrawal from peritoneal dialysis,37.60%;49 patients with withdrawal from peritoneal dialysis to hemodialysis,19.0%;39 patients died,15.1%;4 patients with renal transplantation,1.6% of the withdrawal;5patients lost their visit.Through single factor and multi factor analysis,Combined with cardiovascular and cerebrovascular diseases(HR=2.599,95%CI:1.340~5.043,P=0.005),24-hour urine volume less than 400ml(HR=0.207,95%CI:0.085~0.501,P=0.000),creatinine less than 707umol/L(HR=3.259,95%CI:1.682~6.316,P=0.000)are the independent risk factors for death in patients with peritoneal dialysis.The incidence of peritonitis(HR=3.548,95%CI:1.882~6.691,P=0.000),neutrophil ratio greater than70%(HR=0.543,95% CI:0.302~0.977,P=0.042),uric acid greater than360umol/L(HR=0.352,95%CI:1.168~0.735,P=0.352),total cholesterol greater than 5.7mmol/L(HR=0.368,95%CI:0.160~0.931,P=0.034)are the independent risk factors for conversion to hemodialysis.Conclusion:The outcomes of patients who withdraw from peritoneal dialysis in our center are mainly death and hemodialysis.Cardiovascular and cerebrovascular diseases,24-hour urine volume less than 400 ml,and creatinine less than707umol/L are independent risk factors for death in patients with peritoneal dialysis.Peritonitis,neutrophil ratio greater than 70%,uric acid greater than360umol/L,total cholesterol greater than 5.7mmol/L are independent risk factors for conversion to hemodialysis.