持续非卧床腹膜透析患者血清肌酐水平的影响因素分析

Factors Affecting the Levels of Serum Creatinine in Continuous Ambulatory Peritoneal Dialysis Patients

目的:探讨影响持续非卧床腹膜透析(CAPD)患者血清肌酐水平的因素。方法:选取北京大学第三医院腹透中心200名临床情况稳定的CAPD患者为研究对象。同时收集患者人口学特征、血清肌酐(Scr)及其他生化资料,评估腹膜透析充分性,采用简单相关及多元回归分析探讨影响Scr水平的因素。结果:所有患者平均年龄(61.02±14.81)岁,平均Scr(893±293)μmol/L;简单相关分析显示Scr水平与年龄、总尿素清除指数(TKt/V)、残肾尿素清除指数(RKt/V)、总肌酐清除率(Tccr)及残肾肌酐清除率(Rccr)呈负相关,而与透析剂量、体质指数(BMI)、透析龄呈正相关,差异均具有统计学意义;逐步多元回归分析提示在矫正透析剂量、透析龄及糖尿病等因素后,性别、年龄、Tccr、RKt/V、透析液肌酐浓度/血肌酐浓度(D/PCr)及BMI是影响Scr水平的独立因素(R2=0.659,P<0.05)。结论:本研究提示在剂量、透析龄及糖尿病等因素后,性别、年龄、营养状况、残余肾功能及腹膜转运功能仍能独立地影响CAPD患者血清肌酐水平。

Objective：The aim was to identify the factor affecting the levels of serum creatinine in continuous ambulatory peritoneal dialysis（CAPD）patients.Methods：Two hundreds clinical stable CAPD patients from the peritoneal dialysis center of Peking University Third Hospital were included.Patients＇demographic data,serum creatinine（Scr）and other blood biochemistries indicators were measured,dialysis adequacy also assessed.Simple correlation analysis and stepwise regression analysis were used to explore the factor affecting the levels of Scr.Results：The averaged age and levels of Scr were 61.02±14.81years old and 893±293 μmol/L,respectively.Correlations analysis suggested that Scr was significantly and inversely correlated with age,total KT/V,residual renal KT/V,total Ccr and residual renal Ccr,but positively with dialysis dose,body mass index（BMI）,and dialysis vintage.Multivariate regression analyses revealed that gender、age、residual renal Ccr、residual renal KT/V、ratio of dialysate creatinine to serum creatinine（D/PCr）,and BMI can independently affect the levels of Scr after adjusting for dialysis dose,diabetic status,and dialysis vintage（R2=0.659,P0.05）.Conclusion：Our study suggested that gender,age,nutritional status,residual renal function and peritoneal transport function were indepentdent factors affecting the levels of Scr in CAPD patients after adjusting for dialysis dose,diabetic status,and dialysis vintage.