背景和目的:本研究旨在通过胸部X线摄片和生化指标分析腹膜和血液透析患者的生存率。确定常见的透析病因和死亡原因,揭示预后因素,并有助于临床实践。材料与方法:对2018年10月至2020年2月收集的33例腹膜透析患者和37例血液透析患者的数据进行了回顾性横断面研究。对70个月(2018年10月至2024年6月)的生存率和死亡率进行回顾性追踪。胸部X光测量(心胸指数,肺血管蒂宽度,右肺动脉直径,膈肌高度)和生化参数(尿素,白蛋白,肌酐,甲状旁腺激素,铁蛋白,血红蛋白,动脉血气,钾)分析了它们对存活率的影响。统计分析包括描述性统计,卡方检验,费希尔的精确检验,贝叶斯分析,McNemar测试,Kaplan-Meier生存分析,Cox回归,贝叶斯相关检验,线性回归分析(散点图),ROC分析。采用SPSS20.0进行数据分析,p<0.05被认为具有统计学意义。结果:高血压,2型糖尿病,和泌尿生殖系统疾病是主要的透析病因。腹膜炎(38.5%)和心血管疾病(47.4%)是腹膜和血液透析患者死亡的主要原因,分别。胸部X线显着差异包括血液透析中的肺血管蒂宽度和肺动脉直径以及腹膜透析中的隔膜高度。Kaplan-Meier在方法之间没有显示生存差异。Cox回归识别年龄,完整的副激素水平,iPTH/PVPW比值,和临床状态作为生存和死亡因素。用于死亡率预测的iPTH/PVPW比值截止值≤6.8。结论:年龄,完整的副激素水平,肺血管蒂宽度,和临床状态显着影响透析患者的生存率。高血压和糖尿病的管理,泌尿生殖系统疾病的管理和随访,感染控制,患者教育,定期心血管检查可以提高生存率。此外,iPTH/PVPW比值可以预测死亡风险。
Background and Objectives: This
study aims to analyze survival in peritoneal and hemodialysis patients using chest radiography and biochemical parameters, determine common dialysis etiologies and causes of death, reveal prognostic factors, and contribute to clinical practice. Materials and Methods: A retrospective cross-sectional
study was conducted with data from 33 peritoneal dialysis and 37 hemodialysis patients collected between October 2018 and February 2020. Survival and mortality were retrospectively tracked over 70 months (October 2018-June 2024). Chest X-ray measurements (cardiothoracic index, pulmonary vascular pedicle width, right pulmonary artery diameter, diaphragmatic height) and biochemical parameters (urea, albumin, creatinine, parathormone, ferritin, hemoglobin, arterial blood gas, potassium) were analyzed for their impact on survival. Statistical analyses included descriptive statistics, chi-square test, Fisher\'s exact test, Bayesian analysis, McNemar test, Kaplan-Meier survival analysis, Cox regression, Bayesian correlation test, linear regression analysis (scatter plot), and ROC analysis. SPSS 20.0 was used for data analysis, with p < 0.05 considered statistically significant. Results: Hypertension, type 2 diabetes, and urogenital disorders were the main dialysis etiologies. Peritonitis (38.5%) and cardiovascular diseases (47.4%) were the leading causes of death in peritoneal and hemodialysis patients, respectively. Significant chest X-ray differences included pulmonary vascular pedicle width and pulmonary artery diameter in hemodialysis and diaphragm height in peritoneal dialysis. Kaplan-Meier showed no survival difference between methods. Cox regression identified age, intact parathormone levels, iPTH/PVPW ratio, and clinical status as survival and mortality factors. The iPTH/PVPW ratio cut-off for mortality prediction was ≤6.8. Conclusions: Age, intact parathormone levels, pulmonary vascular pedicle width, and clinical status significantly impact survival in dialysis patients. Management of hypertension and diabetes, management and follow-up of urogenital disorders, infection control, patient education, and regular cardiovascular check-ups may improve survival rates. Additionally, the iPTH/PVPW ratio can predict mortality risk.