腹膜透析患者的退出及住院原因分析

The cause of dropout and hospitalization in peritoneal dialysis patients.

目的 调查腹膜透析患者退出和住院的原因。方法 对90例腹膜透析患者进行追踪,调查其退出时间和退出原因,以及住院时间和住院原因,同时测定透析充分性、营养状况和心血管系统状况等指标。结果 本组90例患者的1年、2年和5年技术生存率分别为94.4％、79.8％和40.1％。退出腹膜透析的首位和次位原因分别是心脑血管系统疾病和感染性疾病。90例患者的年住院次数为0.99±1.04,住院率为16.4天/年。住院的首位和次位原因分别是心脑血管系统疾病和腹膜透析相关性感染,其中容量负荷过重导致心功能衰竭是患者住院的重要原因之一。患者退出腹膜透析的独立危险因素为丧失活动能力和血清CRP水平,住院的独立危险因素为丧失活动能力、SGA水平及血清CRP水平。结论 心脑血管系统疾病和感染性疾病导致腹膜透析患者退出和住院的重要因素。营养、炎症和心血管状态对腹膜透析患者的预后具有重要的影响作用。腹膜炎仍然是导致腹膜透析患者住院和退出的住院原因之一。

Objective To find the cause of dropout and hospitalization in peritoneal dialysis (PD) patients. Methods Ninety PD patients were enrolled. Their dropout and hospitalization were reviewed. Dialysis adequacy, nutritional status and cardiac - cerebral vascular comorbidity were also evaluated. Results The PD patients 1 - year,2 -year and 5-year technique survival 94.4% , 79. 8% and 40. 1% respectively. The main causes of dropout were cardiac-cerebral vascular diseases and infectious disease. These patients had 0.99±1.04 hospitalizations per year and the hospitalization rate was 16.4 days per year. The main causes of hospitalization were cardiac - cerebral vascular diseases and PD related infections. Heart failure due to volume overload was an important cause of hospitalization. Nonactivity and serum CRP level were independent factors to predict the dropout of the PD patients, and hospitalization rate was related to nonactivity, serum CRP level and SGA independently. Conclusion Cardiac - cerebral vascular diseases and infectious diseases were the main cause for dropout and hospitalization in PD patients. Nutritional, Inflammation and cardiovascular status had a great effect on progression of PD patients. Peritonitis is still a cause of dropout and hospitalization in PD patients.