影响腹膜透析患者残余肾功能下降速率的因素

肾脏病与透析肾移植杂志 ›› 2015, Vol. 24 ›› Issue (1): 26-31.

影响腹膜透析患者残余肾功能下降速率的因素

出版日期:2015-02-28 发布日期:2015-03-07

Analysis of the rate of residual renal function decline in peritoneal dialysis patients with different baseline residual renal function

Online:2015-02-28 Published:2015-03-07

摘要/Abstract

摘要：

摘要目的：比较基线时不同残余肾功能(RRF)的腹膜透析(PD)患者的 RRF下降速率，分析RRF下降的相关影响因素。方法：选取行 PD置管术的201例新患者，根据肾小球滤过率(eGFR)水平将其分为A组(eGFR<6 ml/min)、B组eGFR(6-10ml/min)、C组(eGFR>10ml/min)。至少每6个月对患者进行一次临床随访，评估患者的全身情况及透析状态，并计算36个随访月每组 RRF的平均下降速率。结果：A、B、C三组的 RRF平均下降速率分别为-0.089，-0.152，-0.247(ml/min/month, P<0.001)。多元线性回归显示基线时心胸比( rs= -0.238)；三酰甘油( rs= -0.421)、eGFR( rs= -0.557)、血红蛋白( rs= 0.216)分别是 B、C组 rGFR下降速率的独立影响因素（A组没有纳入变量）。在随访末，C组 RRF仍然保持最高的水平且 RRF消失的百分比在3组中最低(P <0.001), 且心力衰竭发生的时间较晚。结论：基线时eGFR高的 PD患者 RRF下降速率快，但其随访末在3组中仍然保持最高的 RRF水平及最低的 RRF消失百分比。

关键词: 腹膜透析, 残余肾功能, 下降速率, 相关因素

Abstract:

ABSTRACT Objective: To compare the residual renal function (RRF) decline in peritoneal dialysis (PD) patients with different baseline residual renal function and explore its relative factors. Methodology: Two hundred one new PD patients were enrolled in this study. They were divided into three groups according to estimated glomerular filtration rate (eGFR)：group A was eGFR <6 ml/min (n=60), group B eGFR 6-10ml/min (n=91), and group C eGFR >10ml/min (n=50). During the follow up, we regularly examined laboratory measurements, and dialysis status was evaluated. The average rate of RRF decline was calculated in three groups after follow-up of 36 months. Results: The average rate of RRF decline was -0.089, -0.152, -0.247(ml/min/month) respectively on group A, group B and group C (P<0.001). By linear multiple regression analysis, the independent factors for the decline of RRF were cardiothoracic ratio (rs= -0.238) in group B, triglyceride (rs= -0.421), eGFR (rs= -0.557) and hemoglobin (rs= 0.216) in group C ( no independent factor was in group A ). At the end of follow-up, the average of RRF in group C was still maximum and the patients have no RRF with the lowest percentage among three groups (P <0.001), and their heart failure occurs later . Conclusion: The RRF declined fastest in the patients with highest baseline RRF, but they maintained the highest RRF at the end of follow-up and have no RRF with the lowest percentage among three groups.

Key words: peritoneal dialysis, residual renal function, decline rate, relative factors

尹飞挺|谌璐|孙洪芹|等. 影响腹膜透析患者残余肾功能下降速率的因素[J]. 肾脏病与透析肾移植杂志, 2015, 24(1): 26-31.

YING Feiting|Chen Lu|SUN Hongqin|et al. Analysis of the rate of residual renal function decline in peritoneal dialysis patients with different baseline residual renal function[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2015, 24(1): 26-31.

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