张春燕 1章倩莹 1杨俪 1崔岩 1徐天 1王朝晖 1任红 1黄晓敏1
作者信息
- 1. 上海交通大学医学院附属瑞金医院肾脏科,上海 200025
- 折叠
摘要
Abstract
Objective To analyze the clinical risk factors and prognosis of elderly peritoneal dialysis patients with peritonitis.Methods A retrospective analysis was conducted on the data of patients who underwent peritoneal dialysis and developed peritonitis at this peritoneal dialysis center between January 2020 and November 2022.Patients were divided into 2 groups according to their age at peritonitis onset:an elderly peritonitis group(age≥65)and a non-elderly peritonitis group(age<65).General information and peritonitis-related data were collected,and the clinical risk factors and prognosis of peritonitis between the 2 groups were compared.Results A total of 62 patients with peritonitis were enrolled,including 26 in the elderly peritonitis group,where the median age was 71(range 65-88),12 patients were male(46.2%),and 5 patients had diabetic nephropathy complicated by diabetes mellitus(19.2%);36 in the non-elderly peritonitis group,where the median age was 48(range 26-63),23 patients were male(63.9%),and 5 patients had diabetic nephropathy complicated by diabetes mellitus(13.9%).The elderly peritonitis group exhibited a worse prognosis than the non-elderly peritonitis group(mortality 30.8%vs.2.8%;technique failure rates 23.1%vs.16.7%,P=0.004).The elderly peritonitis group had a higher proportion of patients with education level of middle school or below(72.2%vs.53.8%,P=0.038),a higher proportion requiring caregivers(100%vs.83.3%,P=0.035),a higher frequency of operator changes(38.5%vs.11.1%,P=0.011),longer initial training time(4 d vs.3 d,P<0.01),and longer dialysis duration(70.5 months vs 29.5 months,P=0.002).The non-elderly peritonitis patients had better nutritional status:both normalized protein catabolic rate(nPCR)(0.90 vs.0.79,P=0.007)and plasma albumin(34.78 g/L vs.30.77 g/L,P<0.01)were higher.The elderly peritonitis group had lower levels of blood creatinine(872.42 μmol/L vs.1053.69μmol/L,P<0.01),blood uric acid(345.0 μmol/L vs.372.0 μmol/L,P=0.023),blood potassium(3.65 mmol/L vs.3.95 mmol/L,P=0.012),blood phosphorus(1.54 mmol/L vs.1.80 mmol/L,P=0.022),intact parathyroid hormone(iPTH)(227.2 pg/mL vs.414.0 pg/mL,P=0.037),and 25-hydroxyvitamin D3(17.95 nmol/L vs.22.57 nmol/L,P=0.007).Conclusions Elderly patients with peritonitis had a poorer prognosis.Compared with younger patients with peritonitis,elderly patients had lower education levels,longer dialysis duration,worse nutritional status,poorer operational ability,and a greater need for caregivers.关键词
腹膜透析/腹膜炎/老年/危险因素Key words
peritoneal dialysis/peritonitis/elderly/risk factors分类
医药卫生
