腹膜透析治疗成人多囊肾终末期肾脏病患者疗效评价

发布时间：2018-01-17 16:08

本文关键词：腹膜透析治疗成人多囊肾终末期肾脏病患者疗效评价　出处：《中国医学科学院学报》2017年04期 　论文类型：期刊论文

【摘要】：目的观察成人多囊肾(PKD)终末期肾病(ESRD)患者的临床指标、透析方式和结局,评价PKD导致ESRD患者接受长期腹膜透析治疗的可行性。方法回顾性收集1993年1月至2015年12月北京协和医院确诊PKD的ESRD患者的临床资料,根据透析方式分为腹膜透析(PKD-PD)组、血液透析(PKD-HD)组,从622例腹膜透析患者中以1∶3选择年龄、性别、开始透析时间与PKD-PD组匹配的非PKD腹膜透析患者作为对照(非PKD-PD组)。以死亡为主要终点事件,利用Kaplan-Meier计算生存率,利用Cox回归模型分析影响患者生存的危险因素。结果共47例PKD患者,包括PKD-PD组33例、PKD-HD组14例,纳入非PKD-PD患者42例作为对照。PKD患者平均年龄(53±11)岁,其中女性患者18例(38.3%)。PKD-PD组与PKD-HD组患者开始透析时年龄、性别、合并症、肾脏大小、残肾功能等差异无统计学意义(P均0.05)。PKD-PD组平均透析时间(36.2±33.1)个月,透析3个月、1年、3年、5年每周尿素清除指数、每周肌酐清除率、残肾功能年下降率与非PKD-PD组相比差异均无统计学意义(P均0.05)。平均腹膜炎发生率为1次/84.5个月,透析1年、3年、5年生存率分别为85.7%、78.6%、78.6%,与PKD-HD组、非PKD-PD组相比差异均无统计学意义(P均0.05)。Cox多因素回归分析显示透析方式不是影响PKD患者预后的独立危险因素。结论腹膜透析可以用于部分PKD导致ESRD患者的长期肾脏替代治疗。
[Abstract]:Objective To observe the effect of adult polycystic kidney disease (PKD) in end-stage renal disease (ESRD) clinical indicators, dialysis and outcome evaluation of PKD resulted in ESRD patients receiving long-term peritoneal dialysis treatment feasibility. Methods the clinical data of patients with ESRD were retrospectively collected from January 1993 to December 2015 in Peking Union Medical College Hospital diagnosed PKD, according to the form of dialysis is divided into peritoneal dialysis (PKD-PD) group, hemodialysis (PKD-HD) group, from 622 cases of peritoneal dialysis patients with 1: 3 age, gender, duration of dialysis and begin to match the PKD-PD group of non PKD in peritoneal dialysis patients as control group (non PKD-PD group). The death as the main end point events, using Kaplan-Meier to calculate the survival rate, survival risk analysis the factors using Cox regression model. Results: a total of 47 PKD patients, including 33 cases of PKD-PD group, PKD-HD group of 14 cases, non PKD-PD patients included 42 cases in.PKD patients (mean age 53 + 11 years), the In 18 cases of female patients (38.3%) in.PKD-PD group and PKD-HD group at the beginning of the age, gender, comorbidity, kidney size, no statistically significant difference in residual renal function (P 0.05).PKD-PD group average dialysis time (36.2 + 33.1) months, dialysis for 3 months, 1 years, 3 years. 5 years of weekly urea clearance index, weekly creatinine clearance rate, annual rate of decline of residual renal function compared with non PKD-PD group showed no significant difference (P < 0.05). The average incidence of peritonitis was 1 times for /84.5 months, dialysis for 1 years, 3 years, 5 years survival rates were 85.7%, 78.6%, 78.6%. PKD-HD group and non PKD-PD group, the differences were not statistically significant (P 0.05).Cox multivariate regression analysis showed that dialysis is not independent prognostic factor in PKD patients. Conclusion peritoneal dialysis can be used for PKD ESRD patients lead to long-term renal replacement therapy.

【作者单位】：中国医学科学院北京协和医学院北京协和医院肾内科;
【基金】：科技部973项目子课题(2012CB517803) 国家自然科学基金(81470937)~~
【分类号】：R692.5
【正文快照】： 多囊肾(polycystic kidney disease,PKD)是最常见的单基因遗传病之一,其特征是肾脏形成大量含有液体的囊性结构,破坏肾脏原有结构和功能,肾脏体积进行性增大。PKD至今无有效治疗措施,是导致终末期肾脏病(end-stage renal disease,ESRD)的第4位病因[1]。研究显示年龄大于60岁的

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