Effect of peritoneal transport characteristics on prognosis of peritoneal dialysis patients: A retrospective cohort study

Objective: We aimed to analyze the clinical characteristics of peritoneal dialysis (PD) patients with different baseline peritoneal transport characteristics and the effect of peritoneal transport characteristics on prognosis of PD patients. Methods: : Patients who received PD for over 1 months in the Nanjing Drum Tower Hospital between January 2006 and December 2019 were included. They were divided into four groups according to the baseline dialysate/plasma creatinine (D/Pcr) value. The clinical characteristics, changes in peritoneal transport, and risk factors of death and technique failure were analyzed. Results: : A total of 323 patients were enrolled, comprising 70 patients in the low transport group, 135 in the low average transport group, 101 in the high average transport group, and 17 in the high transport group. Multivariate logistic regression analysis suggested that male sex (OR = 1.529, 95%CI 1.003–2.330) and low albumin levels (OR = 0.910, 95%CI 0.869–0.952) were risk factors for baseline high peritoneal transport status. The survival rate in the high transport group was significantly lower than that of the low transport (χ 2 = 3.953, P = 0.047), LA (χ 2 = 4.355, P = 0.037) and high average transport groups (χ 2 = 9.359, P = 0.002). There was no significant difference in technique failure rate among these four groups (χ 2 = 0.107, P = 0.991). Multivariate Cox regression analysis suggested that age (HR = 1.053, 95%CI 1.026–1.082), Charlson's comorbidity index (HR = 1.630, 95%CI 1.307–2.032), and baseline high transport (HR = 3.280, 95%CI 1.109–9.699) were independent risk factors for patient death. Male sex (HR = 1.851, 95%CI 1.123–3.052), C-reactive protein levels (HR = 1.008, 95%CI 1.001–1.015), and peritonitis (HR = 2.312, 95%CI 1.430–3.739) were independent risk factors for technique failure. Conclusions: : Initial high peritoneal transport status is an independent risk factor for patient death. Male sex and low albumin levels were determinants of baseline high peritoneal transport.