›› 2017, Vol. 37 ›› Issue (8): 1090-.doi: 10.3969/j.issn.1674-8115.2017.08.008

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Risk factors analysis of initial high peritoneal solute transport status in peritoneal dialysis patients

LIN Tao1*, YU Ge-ping2*, XIE Jing-yuan1, HUANG Xiao-min1, XU Tian1, WANG Li1, 3, LI Xiao1, ZHANG Chun-yan1, XU Yao-wen1, REN Hong1, CHEN Nan1   

  1. 1. Department of Nephrology, Ruijin Hospital, Institute of Nephrology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2. Department of Nephrology, Tonglu Hospital Affiliated to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Tonglu 311500, China; 3. Department of Nephrology, Shidong Hospital of Shanghai Yangpu District, Shanghai 200438, China
  • Online:2017-08-28 Published:2017-09-28
  • Supported by:
    National Key Research and Development Program of China, 2016YFC0904100; National Natural Science Foundation of China, 81570598, 81370015; National Key Clinical Specialist Construction Programs of China; Medical Science and Technology Project of Zhejiang Province, 2015KYB336; Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support, 20152207; International Cooperation and Exchange Project of Shanghai Science and Technology Commitee, 14430721000; Multicenter Clinical Research Program of Shanghai Jiao Tong University School of Medicine, DLY201510; Key Clinical Disciplines Construction Grant Support, Shanghai Municipal Health and Family Commission

Abstract: Objective · To investigate the clinical characteristics of initial peritoneal dialysis (PD) patients with different peritoneal transport status, and analyze risk factors of high peritoneal transport status in PD patients.  Methods · A total of 455 consecutive PD patients newly starting PD between January 2007 to October 2015 were retrospectively analyzed. According to the results of the first sPET, patients were divided into H/HA (4h D/Pcr≥0.65) and L/ LA (4h D/Pcr<0.65) groups. Clinical and biochemical characteristics between the two groups were compared. Multivariate logistic regression model was established to investigate risk factors of higher peritoneal transport status of incident PD patients.  Results · The study included 372 incident PD patients. The L/LA group and H/HA group had 264 cases (71.2%) and 108 cases (28.8%) respectively. The H/HA group had higher proportion of male patients (63.0% vs 50.8%, P=0.03), lower residual renal function [RRF, (4.26±2.77) mL/min vs (5.79±4.53) mL/min, P<0.01], lower serum albumin level [(29.34±6.89) g/L vs (32.08±5.86) g/L, P=0.00], and more frequent diabetic nephropathy (19.4% vs 9.5%, P=0.00), compared with L/LA group. Univariate and multivariate logistic regression analysis showed that higher peritoneal transport status was associated with lower serum albumin level (OR=0.96, 95% CI 0.28-0.99; P=0.02), male (OR=1.92, 95% CI 1.19-3.12; P=0.00), presence of diabetic nephropathy (OR=2.52, 95% CI 1.26-5.05; P=0.00) and lower residual renal function (OR=0.90, 95% CI 0.83-0.96; P=0.00). The level of hsCRP in patients with hypoalbuminemia was higher than that in patients with normal albumin level (1.69 mg/L vs 0.69 mg/L, P=0.00).  Conclusion · Low and low average peritoneal transport status accounted for the majority of the patients in this study. Low serum albumin levels, male, diabetic nephropathy, RRF were risk factors of initial high peritoneal solute transport status. Chronic inflammatory status might partially explain for the correlation between hypoalbuminemia and high peritoneal solute transport status in PD patients.

Key words:  peritoneal solute transport, risk factor, peritoneal dialysis, hypoalbuminemia, residual renal function