血Na浓度预测腹膜透析患者的长期预后

Association between plasma sodium and survival in peritoneal dialysis patients

目的：研究腹膜透析患者的血Na浓度与预后的相关关系。方法：回顾性分析在本院接收持续不卧床腹膜透析治疗的119例患者临床资料，按血Na分为Na<135.5mmol/L组与Na&135.5mmol/L组。连续观察36个月。采用Kaplan-Meiei法比较两组患者生存率，Cox比例风险模型分析血Na浓度与预后的关系。结果：与Na&135.5mmol/L组比较,Na<135.5mmol/L组3年生存率明显下降(/=37.08,P=0.000)。Cox比例风险模型结果显示，与Na&135.5mm〇l/L组比较,Na<135.5mmol/L组患者死亡风险增力n(风险比:1.122,95%C/:1.043~1.209)。患者年龄、血肌酐和血Na浓度为不良肾脏预后的独立危险因素。结论：血Na浓度水平低的腹膜透析患者生存率较低，血Na浓度水平对腹膜透析患者长期预后的评估有较好的价值。

Objective : To evaluate the association between plasma sodium and prognosis in peritoneal dialysis patients. Methods: A total of 119 incident peritoneal dialysis were retrospectively selected, and then were followed-up by 36 months or until death. The patients were divided into Group Na < 135. 5 mmol/L and Group Na^ l 35. 5 mmol/ L. The patients' survival rates were analysied by Kaplan-Meier analysis.Cox proportional hazards analyses were used for elucidating relationship between plasma sodium and allcausemortality in 119 peritoneal dialysis patients. Results: The overall survival rate in Group Na < 135. 5mmol/L was significantly lower than Group Na^ l 35.5 mmol/L (^2 = 3 7 . 0 8 ,P =0.000). By applicationof Cox proportional hazard model, hyponatremia was independently associated with all-cause mortality(ffi?:1. 122 , 9 5 % C/: 1.043 - 1.209 ) . Age, serum creatinine and plasma sodium were significantly correlated with poor renal prognosis. Conclusion; Peritoneal dialysis patients with hyponatremia have poor outcome,and serum sodium level may be helpful to predict the patient survival.