两种透析方式对常染色体显性多囊肾病预后影响

Prognostic factors for autosomal dominant polycystic kidney disease:a comparative study between peritoneal dialysis and hemodialysis

目的比较血液透析与腹膜透析对进入终末期肾病(ESRD)的常染色体显性多囊肾病(ADPKD)患者预后的影响。方法回顾性分析自1999年3月至2014年8月第二军医大学附属长海医院肾内科收治的43例ADPKD患者的临床资料。根据初始透析方法的不同,将43例患者分为血液腹膜透析组(n=20)及血液透析组(n=23)。随访期间,记录心血管事件发生情况,并对两组患者心血管事件发生率进行比较。以全因死亡为终点事件,绘制生存曲线,采用Kaplan Meier法和LogRank检验对两组患者存活率进行比较。结果本研究共43例患者,最长随访147个月。腹膜透析组心血管事件发生率5.0%(1/20),血液透析组26.1%(6/23),两组间比较,差异有统计学意义(P<0.01)。随访期内,腹膜透析组患者,存活率85.0%(17/20),血液透析组存活率73.9%(17/23),两组间比较,差异无统计学意义(P>0.05)。结论腹膜透析与血液透析均是ADPKD肾衰竭患者的有效肾替代治疗方法。与腹膜透析比较,血液透析患者心血管事件发生概率较低。

Objective To investigate the comparative effects between hemodialysis and peritoneal dialysis on the prognosis of endstage renal disease（ ESRD） of patients with autosomal dominant polycystic kidney disease（ ADPKD）. Methods A retrospective study was performed on 43 patients diagnosed of ADPKD who were received in Changhai Hospital of Second Military Medical University from March 1999 to August 2014. According to the initial dialysis methods,43 patients were divided into the peritoneal dialysis（ PD） group（n = 20） and the hemodialysis（HD） group（n = 23）. During the follow-up period,the cardiovascular events were recorded and the incidence of the cardiovascular events in patients between the two groups were compared. The survivorship curve was drawn on the basis of all-cause mortality as the end point event,and the survival rate between the two groups were compared by Kaplan Meier method and Log-Rank inspection. Results There were 43 patients involved in this study,and the longest follow-up period was 147 months. The incidence of the cardiovascular events in the PD group and the HD group was 5. 0%（1 /20） and 26. 1%（6 /23）,respectively;the difference was statistically significant（ P〈0. 01）. During the follow-up period,and the survival rate in the PD group and HD group was85. 0%（ 17 /20） and 73. 9%（ 17 /23）,respectively;the difference was not statistically significant（ P〉0. 05）. Conclusion Either peritoneal dialysis or hemodialysis is the effective method of renal replacement therapy. Compared with peritoneal dialysis,patients who receive hemodialysis have low cardiovascular events probability.