Effect of fluid and sodium removal on mortality in peritoneal dialysis patients
Effect of fluid and sodium removal on mortality in peritoneal dialysis patients
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DOI：
10.1046/j.1523-1755.2001.060002767.x
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发表时间：
2001-08-01
影响因子：
19.6
通讯作者：
Ertug, AE
中科院分区：
文献类型：
--
作者：
Ates, K;Nergizoglu, G;Ertug, AE
背景腹膜透析（PD）的成功率传统上是通过Kt/V-尿素和总肌酐清除率（TCC）来评估的。然而.这种方法低估了液体和钠去除的重要性。本研究的目的是确定液体和钠去除对PD患者发病率和死亡率的影响。125例PD患者从治疗开始监测3年。人口统计学特征、合并症、腹膜炎发生率的影响。血压.药物、血液生化、腹膜转运特征、残余肾功能（RRF）、Kt/V-尿素、TCC、标准化蛋白氮外观（nPNA）。以及钠和液体的去除对死亡率的影响。还记录了总住院率和心血管住院率。采用考克斯比例风险模型确定死亡率的预测因素。在考克斯模型中，合并症、总钠和液体清除、高血压状态、血清肌酐和RRF是影响生存率的独立因素。相比之下，Kt/V-尿素或TCC不影响调整后的生存率。总钠和液体清除和高血压状态也显着影响住院率。收缩压和舒张压与总液体量（P < 0.001）和钠清除量（P < 0.001）呈负相关。总之，这些发现表明，钠和液体的去除是PD患者死亡率的预测因子。而Kt/V-尿素和TCC不是因素。充分的液体和钠平衡对于PD患者的管理至关重要。
Background. Adequacy of peritoneal dialysis (PD) traditionally is assessed using Kt/V-urea and total creatinine clearance (TCC). However. this approach underestimates the importance of fluid and sodium removal. The aim of this study was to determine the effect of fluid and sodium removal on morbidity and mortality in PD patients.Methods. One hundred twenty-five PD patients were monitored for three years from the beginning of the treatment. The effects of demographic features, comorbidity, peritonitis rate. blood pressure. medications, blood biochemistry, peritoneal membrane transport characteristics, residual renal function (RRF), Kt/V-urea, TCC, normalized protein nitrogen appearance (nPNA). and removal of sodium and fluid on mortality were evaluated. Total and cardiovascular hospitalization rates were also recorded. A Cox proportional hazards model was used to determine factors predicting mortality.Results. In the Cox model, comorbidity, total sodium and fluid removals, hypertensive status, serum creatinine, and RRF ere independent factors affecting survival. In contrast, Kt/V-urea or TCC did not affect the adjusted survivals. Total sodium and fluid removal and hypertensive status also significantly influenced the hospitalization rate. Systolic and diastolic blood pressures were negatively correlated with total fluid (P < 0.001) and sodium removal (P < 0.001).Conclusions. Together, these findings suggest that removal of sodium and fluid is a predictor of mortality in PD patients. whereas Kt/V-urea, and TCC are not factors. Adequate fluid and sodium balance is crucial for the management of patients on PD.