腹膜透析患者转血液透析原因及临床特征分析

摘要 目的：分析腹膜透析（PD）患者转血液透析（HD）原因及临床特征。方法：选取2019年12月～2021年1月30例PD转HD患者和30例PD患者的作为研究对象，将30例PD转HD患者纳入PD转HD组，将30例PD患者纳入PD组，比较两组的组间特征；并建立多因素Logistic模型，分析PD患者转HD的影响因素；另根据随访结果将PD转HD组的10例死亡患者纳入死亡组，将20例存活患者纳入存活组，分析两组的组间特征。结果：PD转HD组白蛋白（Alb）、总蛋白（TP）、血磷（P）明显高于PD组，尿素氮（BUN）、肌酐（Scr）明显低于PD组（P＜0.05）；单因素分析结果显示，原发病、透析不良事件、Alb均是影响PD患者转HD的相关因素（P＜0.05）；Logistic多因素分析结果显示，DN、腹透相关性感染、透析不充分、腹透管功能障碍、Alb下降均是PD患者转HD的独立危险因素（P＜0.05）；与存活组比较，死亡组患者DN率较高，Alb水平较低（P＜0.05）。结论：导致PD患者转HD的原因包括腹透相关性感染、透析不充分、腹透管功能障碍、Alb降低等，DN患者较为多见，且DN和Alb降低的患者预后不良风险较高。

Analysis of the Causes and Clinical Characteristics of Peritoneal Dialysis Patients Transferred to Hemodialysis

ABSTRACT Objective: To analyze the causes and clinical characteristics of peritoneal dialysis ( PD ) patients transferred to hemodialysis (HD). Methods: Thirty patients with PD to HD and 30 patients with PD from December 2019 to January 2021 were selected as the study subjects, 30 patients with PD to HD were included in the PD to HD group, 30 patients with PD were included in the PD group, and the intergroup characteristics of the two groups were compared; and a multifactorial logistic model was established to analyze the influencing factors of PD patients to HD; another PD to HD group was included in the PD to HD group according to the follow-up results, and 20 surviving patients were included in the survival group, and the intergroup characteristics of the two groups were analyzed. In addition, 10 patients who died in the PD to HD group were included in the death group, and 20 patients who survived were included in the survival group, and the intergroup characteristics of the two groups were analyzed. Results: The albumin (Alb), total protein (TP) and serum phosphorus (P) in the PD to HD group were higher than those in the PD group, and the urea nitrogen (BUN) and creatinine (Scr) were lower than those in the PD group(P<0.05). Univariate analysis showed that primary disease, dialysis adverse events, and Alb were all related factors affecting HD in PD patients(P<0.05). Logistic multivariate analysis showed that DN, peritoneal dialysis-related infection, inadequate dialysis, peritoneal dialysis tube dysfunction and Alb decrease were independent risk factors for HD in PD patients (P<0.05). Compared with the survival group, the DN rate of the death group was higher and the Alb level was lower, the difference was statistically significant(P<0.05). Conclusion: The causes of HD in PD patients include peritoneal dialysis-related infection, inadequate dialysis, peritoneal dialysis tube dysfunction, and Alb reduction. DN patients are more common, and patients with DN and Alb reduction have a higher risk of poor prognosis.