Abstract:

Objective To investigate the risk factors of pulse pressure, and explore the association of pulse pressure with mortality in patients undergoing peritoneal dialysis. Methods Patients aged over 18 and had a history of peritoneal dialysis for more than 6 months were selected, and the related clinical data of patients were collected. Mean blood pressure in the first 6 months of peritoneal dialysis was obtained, and baseline pulse pressure was calculated. All patients were followed up till death, cessation of peritoneal dialysis, transfer to the other centers, lost in follow-up or to the end of the study (December 31, 2010). Multivariate linear regression was employed to determine the independent influencing factors of pulse pressure, and the association of pulse pressure with mortality was explored with multivariate Cox proportional hazards model. Results A total of 498 patients undergoing peritoneal dialysis were included. Multivariate linear regression revealed that age (β=2.34，P<0.001), serum albumin (β=-0.235，P=0.004) and diabetes (β=4.93，P<0.001) were independent influencing factors of pulse pressure. Univariate analysis demonstrated that pulse pressure was closely associated with all-cause death (HR=1.017, 95%CI 1.007-1.027, P<0.001) and cardiovascular death (HR=1.016, 95%CI 1.003-1.030, P=0.019). Multivariate Cox proportional hazards model indicated that advanced age (HR=1.065, 95%CI 1.047-1.082, P<0.001), low serum albumin (HR=0.945, 95%CI 0.909-0.983, P=0.005) and low hemoglobin (HR=0.981, 95%CI 0.971-0.991, P<0.001) were independent risk factors of all-cause death, and advanced age (HR=1.041, 95%CI 1.016-1.066, P=0.001) and low hemoglobin (HR=0.983, 95%CI 0.969-0.996, P=0.014) were independent risk factors of cardiovascular death. However, pulse pressure was not an independent risk factor of allcause death (HR=1.019, 95%CI 0.996-1.043, P=0.104) and cardiovascular death (HR=0.988, 95%CI 0.860-1.136, P=0.870) in the model after multivariate adjustment. Conclusion Age, serum albumin and diabetes are independent influencing factors of pulse pressure in patients undergoing peritoneal dialysis. The association of pulse pressure with mortality in patients undergoing peritoneal dialysis needs further study.

Key words: peritoneal dialysis, mortality risk, pulse pressure, arteriosclerosis