林伟珍^1,2,,
刘春艳^1,,,
孙晶娣¹
1. 大连医科大学附属第二医院 肾脏内科，辽宁 大连 116023
2. 中山大学附属第一医院贵州医院 体检中心，贵州 贵阳 550000

详细信息 作者简介: 林伟珍（1993-），女，住院医师。E-mail：617351892@qq.com



通讯作者: 刘春艳，教授。E-mail：15541117239@163.com 中图分类号: R692.5


摘要:目的探讨腹膜透析患者的生存率及基线指标对生存时间的影响。方法选取2006—2019年行腹膜透析置管术的372例慢性肾衰竭患者，收集年龄、性别、原发病、腹膜透析前有无血液净化治疗史、血红蛋白、血清白蛋白、电解质等22项指标及转归情况，采用寿命表法估算生存率和技术生存率，Cox比例风险回归模型分析影响生存的危险因素。结果中位生存时间为53.49月，第1、5、10年生存率分别为92%、44%、12%。有临时血液净化治疗史（HR 1.711，95%CI 1.130～2.590，P=0.011）、年龄增加（HR 1.059，95%CI 1.043～1.075，P＜0.001）、糖尿病（HR 1.775，95%CI 1.244～2.532，P=0.002）是腹膜透析患者死亡的独立危险因素，血清白蛋白增加（HR 0.950，95%CI 0.971～0.983，P=0.003），死亡风险降低。无临时血液净化史的患者，肾功能受损至终末期肾病时间越长，死亡风险越低（HR 0.994，95%CI 0.989～1.000，P=0.047）。结论腹膜透析前有临时血液净化治疗史、年龄增加、原发病为糖尿病及低基线血清白蛋白使慢性肾衰竭腹膜透析患者生存时间缩短，短期快速进展的慢性肾脏病患者腹膜透析的远期预后差。
关键词: 终末期肾脏病/
腹膜透析/
死亡率/
生存分析


Abstract:ObjectiveTo study the survival rate of peritoneal dialysis patients and the impact of baseline indicators on survival time.MethodsTotally 372 patients with chronic renal failure, who underwent peritoneal dialysis from 2006 to 2019, were enrolled in the study. The 22 clinical indicators (age, gender, primary disease, blood purification therapy before peritoneal dialysis, hemoglobin, serum albumin, electrolyte, etc.) and outcomes were collected to estimate survival rate and technique survival rate via the lifespan method, while Cox's proportional hazards regression model was utilized to analyze the risk factors that influence survival.ResultsThe overall median survival time was 53.49 months, and the 1, 5, and 10-year survival rates were 92%, 44%, and 12%, respectively. History of temporary blood purification treatment before peritoneal dialysis (HR 1.711, 95%CI 1.130-2.590, P=0.011), advanced age (HR 1.059, 95%CI 1.043-1.075, P＜0.001) and diabetes mellitus (HR 1.775, 95%CI 1.244-2.532, P=0.002) were independent risk factors for mortality, while increased serum albumin (HR 0.950, 95%CI 0.971-0.983, P=0.003) was associated with a low risk of death. The longer time from kidney damage to end-stage renal disease was observed in the patients without temporary blood purification treatment, indicating decreased death risk (HR 0.994, 95%CI 0.989-1.000, P=0.047).ConclusionTemporary blood purification treatment before peritoneal dialysis, advanced age, diabetes mellitus, and lower serum albumin may reduce the survival time of patients with end-stage renal disease on peritoneal dialysis. Short-term rapidly progressive chronic kidney disease has been linked to poor long-term prognosis in peritoneal dialysis patients with chronic kidney disease.
Keywords:end-stage renal disease/
peritoneal dialysis/
mortality/
survival analysis

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