Comparison of the effects of hemodialysis and peritoneal dialysis for elderly patients with end-stage renal disease / 中国基层医药

ABSTRACT

Objective To compare the effects of hemodialysis (HD) and peritoneal dialysis (PD) in the treatment of elderly patients with end-stage renal disease.Methods The clinical data of 100 elderly patients with end-stage renal disease who were treated in the People's Hospital of Beilun District from March 2013 to April 2015 were retrospectively analyzed.The patients were divided into HD group and PD group according to the treatment methods,with 50cases in each group.The 2-year survival rate of the patients in the two groups was observed,and the differences of renal function,nutritional index and lipid metabolism were compared between the two groups before and after treatment.Results Before treatment,there were no statistically significant differences between the two groups in the levels of proinflammatory cytokines.After treatment,the levels of IL-18 [(56.22 ± 7.32) mg/L],IL-6 [(12.18 ± 2.03)mg/L] and hs-CRP[(8.54 ± 1.12)mg/L] in the HD group were lower than those in the PD group [(78.46 ± 7.28) mg/L,(15.23 ± 2.25) mg/L,(10.23 ± 1.67) mg/L] (t =15.233,7.117,5.943,all P ＜ 0.001).After treatment,the levels of BUN [(6.22 ± 1.05) mmol/L],SCr[(115.44 ± 10.84) μmol/L] in the HD group were lower than those in the PD group [(8.87 ± 1.22) mmol/L,(134.52 ± 15.23) μmol/L] (t =5.943,7.217,all P ＜ 0.001),the GFR[(8.15 ± 13.35)mL/min] of the HD group was higher than that of the PD group [(9.26 ± 12.58) mL/min] (t =-4.969,P ＜ 0.001).Before treatment,the nutrition indicators between two groups had no statistically significant difference.After treatment,the levels of ALB [(53.62 ± 4.13)g/L],PA[(342.15 ± 15.02) mg/L] and Hb [(115.86 ± 10.02)g/L] in the HD group were higher than those in the PD group [(45.95 ± 5.57) g/L,(228.36 ± 12.23) mg/L,(98.02 ± 7.12) g/L] (t =-7.821,-41.541,-10.263,all P ＜ 0.001).Before treatment,the lipid metabolism indicators between the two groups had no statistically significant differences(all P＞0.05).After treatment,the levels of TC[(4.78 ±0.98) mmol/L],LDL[(2.51 ±0.97) mmol/L] in the HD group were lower than those in the PD group [(5.53 ± 1.02) mmol/L,(2.89 ± 1.03) mmol/L] (t =3.749,1.899,all P ＜ 0.05),the level of HDL [(1.39 ± 0.46) mmol/L] of the HD group was higher than that of the PD group [(1.22 ± 0.34) mmol/L] (t =-2.101,P ＜ 0.001).The 2-year survival rate in the HD group was 96.00％,and that in the PD group was 86.00％.There was no statistically significant difference between the two groups in the 2-year survival rate (P ＞ 0.05).Conclusion HD has better therapeutic effect on elderly patients with end-stage renal disease,it can significantly improve the metabolic level of patients and improve the survival rate of patients.