Analysis of outcomes and risk factors in peritoneal dialysis patients in a single center

Objective To analyze the clinical data of peritoneal dialysis(PD)patients in the Second Hospital of Shanxi Medical University,and to explore the outcomes of patients with PD and the risk factors.Methods The clinical data of patients with maintenance peritoneal dialysis from January 2009 to June 2019 in the Second Hospital of Shanxi Medical University were collected by retrospective study.The chi-square test and log rank test were used for single factor analysis.Multivariate analysis was performed using a multivariate stepwise COX regression model to discuss the adverse outcomes and risk factors of peritoneal dialysis patients.Results Among 258 patients with maintenance peritoneal dialysis,the ones with chronic glomerulonephritis accounted for 42.2%,the ones with diabetic nephropathy 32.9%;97 ones withdrew from peritoneal dialysis with a withdrawal rate of 37.60%.Among the patients with withdrawal from peritoneal dialysis,49 ones changed from peritoneal dialysis to hemodialysis,accounting for 19.0%;39 ones died,accounting for 15.1%;4 ones underwent renal transplantation,accounting for 1.6%;5 patients lost their follow-up visit.Through single factor and multi factor analysis,the complication of cardiovascular and cerebrovascular diseases(HR=2.599,95%CI:1.340~5.043,P=0.005),24-hour urine volume less than 400 mL(HR=0.207,95%CI:0.085~0.501,P<0.001),creatinine less than 707 μmol/L(HR=3.259,95%CI:1.682~6.316,P<0.001)were the independent risk factors for death in patients with peritoneal dialysis.The incidence of peritonitis(HR=3.548,95%CI:1.882~6.691,P=0.000),neutrophil percentage greater than 70%(HR=0.543,95%CI:0.302~0.977,P=0.042),uric acid greater than 360 μmol/L(HR=0.352,95%CI:0.168~0.735,P=0.005),total cholesterol greater than 5.7mmol/L(HR=0.368,95%CI:0.160~0.931,P=0.034)were the independent risk factors for change to hemodialysis.Conclusions The outcomes of patients who withdraw from peritoneal dialysis in our center are mainly death and change to hemodialysis.The complication of cardiovascular and cerebrovascular diseases,24-hour urine volume less than 400 mL,and creatinine less than 707 μmol/L are independent risk factors for death in patients with peritoneal dialysis.Peritonitis,neutrophil percentage greater than 70%,uric acid greater than 360 μmol/L,total cholesterol greater than 5.7 mmol/L are independent risk factors for change to hemodialysis.