Association between serum chloride levels with mortality in incident peritoneal dialysis patients

医学 腹膜透析 连续不卧床腹膜透析 血清氯化物 糖尿病 内科学 透析 回顾性队列研究 死亡率 危险系数 肾脏疾病 比例危险模型 置信区间 胃肠病学 内分泌学 氯化物 材料科学 冶金
作者
Hongyu Li,Yating Wang,Yiping Xu,Kefei Wu,Xiaohui Lu,Yagui Qiu,Xiao Yang,Qinghua Liu,Haiping Mao
出处
期刊:Nutrition Metabolism and Cardiovascular Diseases [Elsevier BV]
卷期号:32 (3): 624-631 被引量:5
标识
DOI:10.1016/j.numecd.2021.12.007
摘要

Lower serum chloride (Cl) levels have been associated with excess mortality in pre-dialysis chronic kidney disease patients. However, the relationship between serum Cl levels and clinical outcomes in continuous ambulatory peritoneal dialysis (CAPD) patients is unclear.In this retrospective cohort study, we enrolled 1656 eligible incident patients undergoing CAPD from 2006 to 2013, and followed until December 2018. Cox regression analyses were used to examine the association between baseline and time-varying serum Cl levels and mortality. During a median follow-up of 46 months, 503 patients (30.4%) died. In analyses of baseline serum Cl, the adjusted hazard ratios (HR) for tertile 1 (<100.0 mmol/L), tertile 2 (100.0-103.0 mmol/L) versus tertile 3 (>103.0 mmol/L) were 2.34 [95% confidence interval (CI) 1.43-3.82] and 1.73 (95% CI 1.24-2.42) for all-cause mortality, 2.86 (95% CI 1.47-5.56) and 1.90 (95% CI 1.19-3.02) for cardiovascular disease (CVD) mortality, respectively. And a linear relationship was observed between serum Cl and mortality. Further, the inverse association between serum Cl and CVD mortality was particularly accentuated in the patients who were ≥50 years or with a history of diabetes. Similarly, lower time-varying serum Cl levels were also associated with a significant increased risk of all-cause and CVD death.Lower serum Cl levels predicted higher risk of all-cause and CVD mortality in CAPD patients.
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