李 俊,张方杰,陈 婧,安 玲

目的：分析不同年龄段腹膜透析（PD）患者的临床特点及预后。方法：选择青海省人民医院肾内科行CAPD治疗并持续至少3个月以上的ESRD患者，将其分为青年组（年龄为18-44岁），中年组（年龄为45-59岁)，老年组（年龄≥60岁），通过数据分析各个年龄段CAPD患者的临床特点及影响预后的因素。结果：与青年组相比，中年组的SI、UA水平较低（P＜0.05），老年组Alb水平较低（P＜0.05），而GLU水平较高（P＜0.05）；随访1年后，与青年组相比，中年组VitB12水平较高（P＜0.05），老年组SF、VitB12、GLU水平较高（P＜0.05），UA、PTH、P水平较低（P＜0.05）；3.转归：死亡132例，转血透132例，肾移植患者33例，转出患者2例。老年组继续行CAPD患者低于青年组及中年组（P＜0.05）。影响因素：低HB、低TP、低Mg是青中老年组的独立危险因素；而低HB、低TP、低Mg也是汉族组独立危险因素。结论：1.青年组中低血红蛋白和高血磷显著增加CAPD患者预后死亡风险；老年组中总蛋白水平是CAPD患者预后关键的独立保护因素。3.血红蛋白、白蛋白及总蛋白水平是CAPD患者预后生存的强预测因子，低水平与死亡风险显著相关。

腹膜透析；年龄；危险因素

[1] Luxia Zhang,Ming-Hui Zhao,Li Zuo,et al.China Kidney Disease Network(CK-NET)2016 Annual Data Report[J].Kidney International Supplements,2020,10(2):e97-e185; [2] Paul E.Stevens,Sofia B.Ahmed,Juan Jesus Carrero,et al.KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease[J].Kidney International,2024,105(4S):S117-S314. [3] Hyunsuk Kim,Jung Nam An,Dong Ki Kim,et al.Elderly Peritoneal Dialysis Compared with Elderly Hemodialysis Patients and Younger Peritoneal Dialysis Patients:Competing Risk Analysis of a Korean Prospective Cohort Study[J].Plos One,2015,10(6):e0131393. [4] Konstadina Griva,Zhenli Yu,Sally Chan,et al.Age is not a contraindication to home-based dialysis-Quality-of-Life outcomes favour older patients on peritoneal dialysis regimes relative to younger patients[J].Journal of Advanced Nursing,2014,70(8):1902-14. [5] Simon Duquennoy,Clémence Béchade,Christian Verger,et al.Is Peritonitis Risk Increased in Elderly Patients on Peritoneal Dialysis? Report from the French Language Peritoneal Dialysis Registry(RDPLF)[J].Peritoneal Dialysis International:Journal of the International Society for Peritoneal Dialysis,2016,36(3):291-6. [6] Yoshifumi Hamasaki,Kent Doi,Mototsugu Tanaka,et al.Increased peritoneal permeability at peritoneal dialysis initiation is a potential cardiovascular risk in patients using biocompatible peritoneal dialysis solution[J].Bmc Nephrology,2014,15:173. [7] Ji-Chao Guan,Wei Bian,Xiao-Hui Zhang,et al.Influence of Peritoneal Transport Characteristics on Nutritional Status and Clinical Outcome in Chinese Diabetic Nephropathy Patients on Peritoneal Dialysis[J].Chinese Medical Journal,2015,128(7):859-64. [8] Jialing Zhang,Xiangxue Lu,Han Li,et al.Risk factors for mortality in patients undergoing peritoneal dialysis:a systematic review and meta-analysis[J].Renal Failure,2021,43(1):743-753. [9] Charlotte M Mosterd,Charles F Hayfron-Benjamin,Bert-Jan H van den Born,et al.Ethnic disparities in the association between low-grade inflammation biomarkers and chronic kidney disease:The HELIUS Cohort Study[J].Journal of Diabetes and Its Complications, 2022,36(8):108238. [10] Charles Agyemang,Marieke B Snijder,David N Adjei,et al.Ethnic Disparities in CKD in the Netherlands:The Healthy Life in an Urban Setting(HELIUS)Study[J].American Journal of Kidney Diseases:the Official Journal of the National Kidney Foundation,2016,67(3):391-9. [11] Tsutomu Sakurada,Masanobu Miyazaki,Masaaki Nakayama,et al.Peritoneal dialysis-related infections in elderly patients[J].Clinical and Experimental Nephrology,2024,28(11):1065-1074. [12] Papacocea Raluca-Ioana,Timofte Delia,Tanasescu Maria-Daniela,et al..Kidney aging process and the management of the elderly patient with renal impairment(Review)[J].Experimental and therapeutic medicine,2021,21(3):266.

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