Risk factors for peritoneal dialysis drop-out in patients with end-stage kidney disease / 第二军医大学学报

ABSTRACT

Objective To analyze the baseline detection indicator and clinical data of peritoneal dialysis (PD) patients with end-stage kidney disease (ESKD) and to identify the risk factors for PD drop-out in ESKD patients, so as to provide reference for selecting dialysis modes. Methods The baseline data of 99 ESKD patients starting to receive PD in Changzheng Hospital, Second Military University from July 2011 to July 2012, were analyzed retrospectively. The patients were divided into drop-out group (including patients who were dead and turned to hemodialysis) and continuous PD group according to whether they were dropped out during a follow-up of 3 years. Correlation analysis was done for preoperative examination indices and clinical data to identify the risk factors of PD drop-out. Results Ten renal transplant patients and 6 who were lost in follow-up were excluded and finally there were 83 patients included. Fifty patients were in the continous PD group and 33 patients were dropped out during a 3-year follow-up period, with 19 died and 14 transferred to hemodialysis. Multivariate Cox regression analysis showed that presence of diabetes (P=0.003, HR3.61, 95% CI1.57-8.30), hyperphosphatemia (P<0.001, HR1.65, 95% CI1.26-2.13), and high serum total bilirubin (P=0.006, HR1.11, 95% CI1.03-1.19) were the independent risk factors of PD drop-out. In addition, age (P=0.035, HR1.05, 95% CI1.00-1.07) and anemia (P=0.016, HR0.96, 95% CI0.94-0.99) were the independent risk factors for all-caused mortality. Conclusion Presence of diabetes, hyperphosphatemia, and high serum total bilirubin are possible independent risk factors of PD drop-out.