[Clinical characteristics and the factors relevant to peritoneal transport function in patients with continuous ambulatory peritoneal dialysis]

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Jun 28;42(6):623-628. doi: 10.11817/j.issn.1672-7347.2017.06.004.
[Article in Chinese]

Abstract

To observe the clinical characteristics with different peritoneal transport type in patients with continuous ambulatory peritoneal dialysis (CAPD), and to investigate the factors associated with peritoneal transport function. Methods: The clinical data of 158 CAPD patients were analyzed retrospectively. According to peritoneal equilibration test, a method for evaluation of the peritoneal transport function, the patients were divided into 2 groups: a high average and high peritoneal transport group (Group A, n=84) and a low average and low peritoneal transport group (Group B, n=74). The demographics, clinical biochemical indexes and the incidence of cardiovascular complications were compared between the 2 groups. Logistic regression analysis was used to find the factors relevant to peritoneal transport function. Results: The level of serum albumin (ALB) in the Group B was significantly higher than that in the Group A (P<0.05). The 4 h dialysate/plasma creatinine (D/Pcr), high-sensitivity C-reactive protein (hs-CRP), body mass index (BMI), and the rates of cardiovascular complications in the Group A were significantly higher than those in the Group B (P<0.05). Correlation analysis showed that the D/Pcr was positively correlated with the BMI, serum hs-CRP and cardiovascular complications (r=0.179, 0.373 and 0.426, respectively, P<0.05), while it was negatively correlated with ALB (r=-0.393, P<0.01). Logistic regression analysis showed that the high BMI (OR=1.178, P<0.05), cardiovascular complications (OR=5.035, P<0.01), and the low serum ALB (OR=0.852, P<0.01) were the risk factors for high peritoneal transport. Conclusion: The serum ALB level, BMI and the cardiovascular complications are associated with high peritoneal transport, which are useful markers for predicting the peritoneal transport function before peritoneal dialysis.

目的:观察不同腹膜转运类型的持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者的临床特征,探讨影响腹膜转运功能的相关因素。方法:回顾性总结158例CAPD患者的临床资料,根据腹膜平衡试验评价患者的腹膜转运功能并将其分为高平均转运+高转运组(A组,n=84)和低平均转运+低转运组(B组,n=74),并对两组患者的人口学资料、临床生物化学指标以及心血管并发症情况进行比较;应用logistic回归分析寻找影响患者腹膜转运功能的相关因素。结果:B组患者血清白蛋白(albumin,ALB)水平显著高于A组(P<0.05)。A组患者的4 h透析液肌酐与血肌酐浓度的比值(dialysate/plasma creatinine,D/Pcr)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、体重指数(body mass index,BMI)及心血管并发症的发生率均显著高于B组(均P<0.05)。相关分析显示:D/Pcr与BMI,hs-CRP和心血管并发症呈正相关(分别r=0.179,0.373和0.426,均P<0.05);与ALB呈负相关(r=–0.393,P<0.01)。Logistic回归分析显示:高BMI(OR=1.178,P<0.05)、心血管并发症(OR=5.035,P<0.01)以及低血清ALB(OR=0.852,P<0.01)为患者腹膜高转运的危险因素。结论:腹膜透析患者血清ALB水平、BMI和心血管并发症与腹膜高转运相关,可作为预估患者腹膜转运功能的参考指标。.

MeSH terms

  • Body Mass Index*
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / complications*
  • Creatinine / blood
  • Dialysis Solutions
  • Humans
  • Peritoneal Dialysis, Continuous Ambulatory*
  • Peritoneum / metabolism*
  • Regression Analysis
  • Retrospective Studies
  • Serum Albumin / analysis*

Substances

  • Dialysis Solutions
  • Serum Albumin
  • C-Reactive Protein
  • Creatinine