The Comparative Analysis of Peritoneal Dialysis Treatment between Diabetic Nephropathy and Non-diabetic Nephropathy in Uremia Patients

Object:1 To investigate the transfer case of maintenance peritoneal dialysis patients in our hospital.2 By comparing the diabetic nephropathy and non-diabetic nephropathy with uremia of maintenance peritoneal dialysis patients the general situation, complications and prognosis, analysis of two groups of patients living conditions and quality of life to guide clinical treatment and improve prognosis in patients .Methods: According to the original disease of end-stage renal disease, the patients in our hospital’s peritoneal dialysis center from January 2003 to December 2007 were divided into diabetic nephropathy and non-diabetic nephropathy group, the age, sex, blood pressure, hemoglobin level, blood lipids, nutritional status, urine output, dialysis dose, ultrafiltration volume, dialysis adequacy, combined drug therapy, the incidence of peritonitis, cardiovascular complication and duration of dialysis were compared of two groups of patients, Analysis the effect of original disease on the clinical prognosis of peritoneal dialysis patients.Results: To observe the long-term follow-up period of peritoneal dialysis patients with a total of 180 cases, of which diabetic nephropathy 48 cases(26.67%) and non-diabetic nephropathy group 132 cases (73.33%). 1. The patients of DN group have the older average age but a shorter dialysis duration(P <0.05) compare to the non-DN group; 2. After dialysis the patients in DN group achieved the aim blood pressure were 13 cases (27.08%), and in non-DN group were 45 cases (34.09%), (P > 0.05). 3. After dialysis the Hb levels in the two groups were 80.19±17.41 VS 82.58±17.01g / L, (P > 0.05). 4. The eGFR in DN group and non-DN group were compared, 8.64±2.84 VS 5.78±2.11m1/min (P <0.05). 5. The TG level of pre-dialysis patients with two groups is 5.40±0.76 VS 5.22±0.86mmol / L (P <0.05) and the T-CHO level is 1.67±0.65 VS 1.61±0.53mmol / L (P > 0.05). The TG level of after dialysis patients is 5.55±0.77 VS 5.33±0.70mmol / L (P > 0.05), and T-CHOL level is 1.80±0.71 VS 1.70±0.51mmol / L (P > 0.05). 6. The albumin level which before dialysis is 35.85±3.63 VS 36.76±5.46g/L,(P> 0.05).and after is 33.24±3.46 VS 35.18±5.15g / L,( P <0.05). 7. The two groups of patients with no significant differences in serum calcium level, but phosphorus level is 2.17±0.63 VS 2.42±0.75mmol / L (P <0.05), and with high calcium phosphate product in DN group were 8 cases (16.15%), and in non-DN group were 46 cases(34.85%). 8.74 patients were measured eGFR which including 25 cases in ND group and 49 cases in non-DN group : 7.20±2.91 VS 5.78±2.11ml/min, (P <0.05). 9. Ultrafiltration volume was compared between two groups: 763.33±338.14 VS 881.67±263.04ml/d,( P <0.05). 10. The incidence rate of peritonitis were 1/18.45 VS 1/25.15 in patients of two groups (P <0.05). 11. There were total of 108 patients have a Cardiovascular complication in the two groups, of which 36cases in DN group (75.00%),and 72 cases in non-DN group (54.55%), (P <0.05). 12. The total rate of the patients who terminated Peritoneal dialysis was 105 cases(58.33%), of which 34cases (70.83%) in DN group, and 71 (53.79%)cases in non-DN group,(P <0.05). 13. After dialysis there were 77 patients (42.78%) whose serum Alb were normal, the incidence rate of peritonitis was 1/38.70patients’months, the occurrence of cardiovascular events were 26 cases (33.77%), the patients who terminated Peritoneal dialysis was 33 cases(42.86%), but the number of patients with poor albumin levels (<35g/L) were 103 cases (57.22%), the incidence rate of peritonitis was 1/17.26,and The incidence of cardiov- ascular complication were 82 cases(79.61%), the patients who terminated Peritoneal dialysis was 72 cases(69.90%), this two groups have significant differences (P<0.05).The patients that ages≧65 were 65 cases(36.11%), the incidence rate of peritonitis was 1/16.78patients’months, the occurrence of cardiovascular events were 51 cases (78.46%). The patients that ages<65 were 115 cases(63.89%), the incidence rate of peritonitis was 1/27.01patients’months, the occurrence of cardiovascular events were 57 cases (49.57%). this two groups also have significant differences (P<0.05)Conclusion: Diabetic patients with end-stage renal disease is older and have a high rate of cancel peritoneal dialysis and a worse prognosis compare to the non-diabetic patients with RSRD. However, further analysis showed that the prognosis in diabetic nephropathy patients related to the age ,hypoproteinemia, poor nutritional situations of the patients.