Complications and prognosis of urgent-start peritoneal dialysis and urgent-start hemodialysis in end-stage renal disease patients
10.3760/cma.j.issn.1001-7097.2016.10.004
- VernacularTitle:终末期肾病患者不同紧急透析方式的并发症及预后比较
- Author:
Haijiao JIN
;
Wei FANG
;
Mingli ZHU
;
Zanzhe YU
;
Yan FANG
;
Hao YAN
;
Minfang ZHANG
;
Qin WANG
;
Xiajing CHE
;
Yuanyuan XIE
;
Jiaying HUANG
;
Chunhua HU
;
Haifen ZHANG
;
Shan MOU
;
Zhaohui NI
- Publication Type:Journal Article
- Keywords:
Peritoneal dialysis;
Hemodialysis;
Complications;
Survival rates
- From:
Chinese Journal of Nephrology
2016;32(10):739-744
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the complications and outcomes of urgent?start peritoneal dialysis (PD) and hemodialysis (HD) in end?stage renal disease (ESRD) patients, and explore the safety and effectiveness of PD which was as an urgent?start dialysis modality in ESRD patients. Methods All patients for urgent?start dialysis, who initiated dialysis without a long?term dialysis access or had the long?term dialysis access under 30 days in Renji Hospital from January 1st 2013 to December 31st 2014, were enrolled. According to the dialysis modalities, patients were divided into PD group and HD group. Participants were followed up until death, transferred to other centers, lost of follow up or January 1st 2016. Dialysis?related complications within 30 days of implantation, complications of reimplantation and the occurrence of bacteremia between two groups were compared, and their survival rates were tested by Kaplan?Meier curves. Results Among 178 patients in this study, there were 96 (53.9%) patients in PD group and 82 (46.1%) patients in HD group. Compared with those of HD group, patients of PD group presented more cardiovascular disease [21(21.9%) vs 8(9.8%), P=0.029], higher serum potassium [(4.5±0.8) mmol/L vs (4.3±0.8) mmol/L, P=0.038], but less heart failure (NYHA Ⅲ?Ⅳ) [26(30.2%) vs 40 (48.8%), P=0.014], lower brain natriuretic peptide (BNP) [328.5 (129.5, 776.8) ng/L vs 503.5(206.0, 1430.0) ng/L, P=0.008], higher hemoglobin [(81.5 ± 17.7) g/L vs (75.3 ± 22.5) g/L, P=0.039], higher serum albumin (33.5±5.7) g/L vs (31.3±6.7) g/L, P=0.022] and higher serum pre?albumin (304.5±78.0) mg/L vs (257.0 ± 86.1) mg/L, P<0.001]. PD group presented less dialysis?related complications [5 (5.2%) vs 20(24.4%), P<0.001], less dialysis?related complications requiring reimplantation [1(1.0%) vs 20(24.4%), P<0.001] and less bacteraemia [3(3.1%) vs 11(13.4%), P=0.011]. The 3?, 6?and 12?month patient survival rates of PD and HD group were 97.9% vs 98.4%, 97.9% vs 98.4%, and 92.1%vs 93.0% respectively, and no significant difference was found (Log ? rank=0.004, P=0.947). Conclusions Patients with urgent?start PD have less complications within 30 days of implantation and occurrence of bacteremia than patients with urgent?start HD, and the same survival rates. PD may be a feasible and safe urgent?start dialysis modality for ESRD patients.
