单中心老年长期腹膜透析患者转归分析

Retrospective study of outcomes in long-term peritoneal dialysis elderly patients from a single center

目的：探讨单中心老年长期腹膜透析患者的临床转归及临床特点。方法：回顾性列队研究单中心2006~2014年全部长期腹膜透析患者。统计研究事件内的临床数据和临床事件，采用Kaplan–Meier法分析存活率。结果：总计237例腹膜透析患者入选该研究，老年患者50例（≥65岁；中位年龄71.4岁），青年患者187例（〈65岁；中位年龄39.87岁）。老年组患者生存期明显低于青年组（P〈0.01），老年组患者技术性死亡风险于青年组相近。死亡的独立预测因素包括高龄、糖尿病（P〈0.01）、心脑血管疾病（P〈0.01）、低血红蛋白（P〈0.01）、低血清白蛋白（P〈0.01）。结论：老年长期腹膜透析患者的存活率低于年轻患者。老年患者的病死率取决于年龄、是否患糖尿病、血清白蛋白水平。较好的控制老年患者的低蛋白血症及共存疾病能提高患者的生存率。

Objective：To retrospective study the clinical data of long-term peritoneal dialysis（PD） elderly patients from a single center;to discuss the clinical outcomes and clinical features. Methods：This retrospective cohort study included all incident CAPD patients treated at our center from 2006 to 2014. Demographic and clinical data on initiation of CAPD and clinical events during the study period were collected.Survival probabilities were generated using the Kaplan–Meier method. Result：Of 237 patients on CAPD, the elderly group （≥65 years;mean age：71.4 years） consisted of 50 patients, and the younger group （〈65 years;mean age：39.87years） consisted of 187 patients. The patient survival were significantly lower for the elderly group than for the younger group （ P〈0.01）. Kaplan–Meier analysis, It was observed no significant difference in death-censored technique survival between the patient groups.In the patients overall, the independent predictors of death were old age （ P〈0.01）, diabetes （P〈0.01）, cardiovascular disease （P〈0.01）, lower hemoglobin （P〈0.01）, and lower serum albumin （P〈0.01）. Conclusions： The elderly patients on CAPD experienced technique survival comparable with that of younger patients,but their patient survival was lower. In elderly patients,mortality was determined predominantly by greater age,diabetes, and lower serum albumin. Better management of hypoalbuminemia and comorbid conditions might improve survival in elderly PD patients.