nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1999Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESПеритонеальный диализ: ранние предикторы отдаленных результатовPeritoneal dyalisis: early predictors of late outcomesАндрусевА. М.AndrusevA. M.noemail@neicon.ruТитоваН. Л.TitovaN. L.noemail@neicon.ruБикбовБ. Т.BikbovB. T.noemail@neicon.ruТомилинаН. А.TomilinaN. A.noemail@neicon.ruМосковский городской нефрологический центр, городская клиническая больница № 52, г. МоскваRussian Federation20032706202554362368Copyright © Андрусев А.М., Титова Н.Л., Бикбов Б.Т., Томилина Н.А., 20252025Андрусев А.М., Титова Н.Л., Бикбов Б.Т., Томилина Н.А.Andrusev A.M., Titova N.L., Bikbov B.T., Tomilina N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/1999

Целью работы явилось выявление влияния некоторых клинико-биохимических показателей, возраста пациентов и сопутствующей патологии к началу лечения перитонеальным диализом на его отдаленные результаты. Исследованы материалы наблюдений 277 пациентов с ТХПН. Для проведения анализа все пациенты были разделены на две группы: в I группу вошли 148 пациентов с благополучным исходом (продолжавшие ПД к моменту окончания наблюдения и больные, которым была выполнена трансплантация почки), во II группу включены умершие пациенты и переведенные на лечение программным гемодиализом. Отдаленные результаты ПАПД оценивались по выживаемости пациентов и методики ПАПД, для вычисления относительного риска смерти применялась регрессионная модель Cox’а с пропорциональными рисками. Показано, что индекс коморбидности (по M.E. Charlson) является надежным предиктором отдаленных результатов ПД. Неблагоприятными прогностическими признаками являются высокие транспортные свойства брюшины в начале лечения ПД и гипоальбуминемия, выявляемые к началу лечения ПД. Кроме того, снижение уровня альбумина крови на каждый 1 г/л после 36 г/л к началу ПАПД приводит к возрастанию риска смерти больных в 1,1 раза. Также продемонстрировано, что выживаемость больных с сахарным диабетом значимо ниже, чем у пациентов с нефропатиями недиабетической природы.

The aim of the study was to reveal the effect of some clinical and biochemical parameters, patient age and comorbide status on the late result of peritoneal dialysis (PD). 277 patients with ESRD were followed-up. The patients were divided into two groups: 148 patients with successful outcome (continued PD by the end of the follow-up period or those who had kidney transplantation) and unsuccessfully treated patients (died or those who was switched to HD). The late outcome was estimated by survival rate of patients and PD technique. Regression model of Cox was used for calculation of relative death risk. We show that the comorbidity index (M.E. Charlson) is a reliable predictor of the late outcome of PD. Unfavourable risk factors were high permeability of peritoneum and hypoalbuminemia in the beginning of the PD treatment. A decrease in albumin level by 1 g/l below 36 g/l increased the risk of death by a factor of 1,1. It was also shown that the survival rate for diabetics was much lower in comparison with non-diabetic patients.

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The authors declare that there are no conflicts of interest present.