目的  快速腹膜溶质转运率(peritoneal solute transport rate,PSTR)是影响腹膜透析(peritoneal dialysis,PD)患者预后的关键因素，本文旨在探讨PD患者早期出现PSTR的临床危险因素。 方法 采用横断面研究设计，纳入2020年6月─2025年11月于首都医科大学附属北京同仁医院开始PD治疗的终末期肾病患者89例。所有患者于PD治疗3个月(±2周)时行标准腹膜平衡试验，以4 h透析液/血浆肌酐比值(dialysate: plasma creatinine ratio,D/Pcr)≥0.65定义为快速PSTR组，D/Pcr＜0.65者定义为正常PSTR组。通过单因素及多因素Logistic回归分析筛选快速PSTR的独立危险因素。 结果  快速PSTR组患者58例(65.2%)，正常PSTR组31例。单因素分析显示：快速PSTR组患者糖尿病患病率(χ2=10.907，P=0.001)、二氧化碳结合力水平(t=-1.995，P=0.049)及碱性磷酸酶水平(t=-2.343，P=0.021)高于正常PSTR组，而血清白蛋白(t=3.564，P=0.001)、血红蛋白(t=2.447，P=0.017)低于正常PSTR组。相关性分析提示D/Pcr与糖化血红蛋白(r=0.311，P=0.017)、B型钠尿肽(r=0.274，P=0.012)呈正相关，与血清白蛋白(r=-0.481，P＜0.001)、血红蛋白(r=-0.227，P=0.037)呈负相关。多因素Logistic回归分析显示糖尿病病史(OR=4.379，95%CI：1.531～12.522，P=0.006)及血清白蛋白水平降低(OR=0.835，95%CI：0.739～0.943，P=0.004)是发生快速PSTR的独立危险因素。 结论 在PD治疗早期，糖尿病病史和低白蛋白血症是发生快速PSTR的独立危险因素。对于合并糖尿病或营养不良的PD患者，应早期监测腹膜功能，以实现个体化处方管理。

Objective  Rapid peritoneal solute transport rate (PSTR) is a key factor affecting the prognosis of patients on peritoneal dialysis (PD). This study aimed to investigate the clinical risk factors for early development of rapid PSTR in PD patients.  Methods  A cross‑sectional study was conducted, enrolling 89 patients with end‑stage renal disease who initiated PD treatment at Beijing Tongren Hospital, Capital Medical University, between June 2020 and November 2025. All patients underwent a standard peritoneal equilibration test at 3 months (±2 weeks) after PD initiation. Rapid PSTR was defined as a 4-hour dialysate-to-plasma creatinine ratio (D/Pcr)≥0.65, and normal PSTR as D/Pcr＜0.65. Clinical data were collected concurrently, and independent risk factors for rapid PSTR were identified using univariate and multivariate logistic regression analyses.  Results  Fifty‑eight patients (65.2%) were classified as the rapid PSTR group and 31 as the normal PSTR group. Univariate analysis showed that the rapid PSTR group had significantly higher prevalence of diabetes (χ²=10.907, P=0.001), higher levels of carbon dioxide combining power (t=−1.995, P =0.049) and alkaline phosphatase (t=−2.343, P=0.021), and lower levels of serum albumin (t=3.564, P=0.001) and hemoglobin (t=2.447, P=0.017) compared with the normal PSTR group. Correlation analysis revealed that D/Pcr was positively correlated with glycated hemoglobin (r=0.311, P=0.017) and B‑type natriuretic peptide (r=0.274, P=0.012), and negatively correlated with serum albumin (r=−0.481, P＜0.001) and hemoglobin (r=−0.227, P=0.037). Multivariate logistic regression identified a history of diabetes (OR=4.379, 95% CI: 1.531～12.522, P =0.006) and decreased serum albumin level (OR=0.835, 95% CI: 0.739～0.943, P=0.004) as independent risk factors for rapid PSTR. Conclusion  In the early stage of PD, a history of diabetes and hypoalbuminemia are independent risk factors for rapid PSTR. For PD patients with diabetes or malnutrition, early monitoring of peritoneal function is recommended to enable individualized prescription management.