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目的探讨慢性肾脏病(CKD)5期患者在开始腹膜透析时残余肾功能对预后的影响。方法回顾性分析大连医科大学附属第一医院肾内科2006-12-01—2009-04-30行规律性腹膜透析患者118例。按肾小球滤过率(eGFR)(≤5mL/min,>5mL/min)及预后(死亡或存活)分别分为两组。比较开始透析时肾小球滤过率(eGFR)、血红蛋白、血清白蛋白、存活时间(月)、死亡情况。结果 eGFR≤5mL/min组62例,平均存活时间(15.86±1.34)个月,eGFR>5mL/min组56例,平均存活时间(24.05±1.18)个月,差异有统计学意义。eGFR≤5mL/min组患者白蛋白和血红蛋白明显低于eGFR>5mL/min组。Lo-gistic分析显示eGFR≤5mL/min,白蛋白低于30g/L,血红蛋白低于100g/L,年龄大于70岁是死亡的危险因素。结论开始透析时有较高残余肾功能的患者有较长的存活期,残余肾功能、白蛋白、血红蛋白和年龄是死亡的危险因素。
Objective To investigate the effect of residual renal function on prognosis in peritoneal dialysis patients with chronic kidney disease (CKD) stage 5. Methods Retrospective analysis of 118 cases of regular peritoneal dialysis in Department of Nephrology, the First Affiliated Hospital of Dalian Medical University. According to the glomerular filtration rate (eGFR) (≤ 5mL / min,> 5mL / min) and prognosis (death or survival) were divided into two groups. Glomerular filtration rate (eGFR), hemoglobin, serum albumin, survival time (months), and death were compared at the start of dialysis. Results The mean survival time was (15.86 ± 1.34) months in eGFR≤5mL / min group, 56 cases in eGFR> 5mL / min group, the average survival time was (24.05 ± 1.18) months, the difference was statistically significant. Patients with eGFR ≤ 5 mL / min had significantly lower albumin and hemoglobin levels than eGFR> 5 mL / min. Lo-gistic analysis showed that eGFR≤5mL / min, albumin less than 30g / L, hemoglobin less than 100g / L, and age over 70 years old were risk factors of death. Conclusions Patients with higher residual renal function at the start of dialysis have longer survival, residual renal function, albumin, hemoglobin, and age as risk factors for death.