Abstract:

Objective To investigate the effects of changes in cancer antibody 125 (dCA125) level in dialysate from peritoneal dialysis (PD) patients on the prognosis. Methods Patients undergoing continuous ambulatory PD for more than 12 months in PD Center of Renji Hospital, Shanghai Jiao Tong University School of Medicine from January 1, 2005 to December 31, 2009 and with complete data were enrolled. dCA125 levels in dialysate from enrolled patients were measured at the beginning of PD and after 12 months of PD. Patients were assigned to stable dCA125 group and elevated dCA125 group according to the median of dCA125 level changes. All patients were followed up until death, quitting PD, transferring to other centers, lost contact or study termination date (June 30, 2014). KaplanMeier method was used to compare survival, technique survival and peritonitisfree survival time between two groups. Cox proportional hazards model was used to analyze independent risk factors related to the prognosis of patients. Results A total of 111 patients were enrolled with 53 males (477%), a mean age of (535±147) years and 27 diabetic patients (24.3%). The differences in baseline demographics and clinical indexes between two groups were not statistically significant (P>005). Patients in the stable dCA125 group (n=55) developed 73 episodes of peritonitis and the mean incidence of peritonitis was 1/500 patient months. Patients in the elevated dCA125 group (n=56) developed 44 episodes of peritonitis and the mean incidence of peritonitis was 1/753 patient months. The peritonitisfree survival time in the stable dCA125 group was significantly shorter than that in the elevated dCA125 group (logrank 6133, P=0013). The differences in long term survival (logrank 2108, P=0147) and technique survival (logrank 0108, P=0743) between two groups were not statistically significant. Cox proportional hazards model analysis showed that elevated dCA125 level was an independent protective factor for peritonitis (HR 0538，95%CI 0296~0979，P=003). Conclusion Elevated dCA125 level in PD patients is a protective factor for peritonitis and changes in dCA125 level are unrelated to longterm survival and technique survival. Detection of changes in dCA125 level may predict the incidence of peritonitis in PD patients.

Key words: peritoneal dialysis, cancer antibody 125, peritonitis, risk factor