Abstract: Objective To establish and verify a Nomogram incorporating serum cystatin C for the technical survival of non- diabetic peritoneal dialysis (PD) patients. Methods We included non- diabetic patients
who newly admitted to PD treatment in our Hospital between January 2010 to January 2019. Demographic
and biochemical data were collected. Urea clearance index and 4h dialysate to plasma creatinine ratio (4h
D/PCr) were recorded 1 month after starting regular PD treatment. Episodes of peritonitis in the first year of
PD were also recorded. Risk factors for end-point events were analyzed by Cox regression model. The Nomogram was used to evaluate the prediction of the 1,3 and 5-year technical survival rate of PD patients by meaningful indicators. The calibration curve and Harrell concordance index (C-index) were used to verify the accuracy of the Nomogram in predicting the technical survival rates of PD patients. Results We enrolled 163 patients, including 90 males (55.21%) and 73 females (44.78%), with an average age of (48.75±13.23) years.
The serum cystatin C level was (5.56±1.08)mg/L. Univariate Cox regression showed that higher serum cys-tatin C (HR=1.275, 95% CI：1.031～1.577, P=0.026), male (HR=0.582, 95% CI：0.350～0.968, P=0.037),
peritonitis episodes in the first year (HR=1.564, 95% CI：1.002～2.440, P=0.049), and higher 4h D/PCr (HR=
1.217, 95% CI：0.967～1.531, P=0.095) were risk factors for PD failure, while higher serum albumin (HR=
0.928, 95% CI：0.876～0.982, P=0.010), residual renal function (RRF), urea clearance index (Kt/V) (HR=
0.174, 95% CI：0.078～0.388, P＜0.001) and total Kt/V (HR=0.276, 95% CI：0.137～0.554, P＜0.001) were
protective factors for PD technical survival. Because serum cystatin C had a collinearity with RRF Kt/V and
total Kt/V, the Kt/V measurements were excluded. After incorporating the covariates with P ＜0.1 into a multivariate Cox regression, serum cystatin C was an independent risk factor for PD failure (HR=1.288, 95% CI：
1.032～1.603, P=0.025). The C-index of Nomogram predicting the technical survival rate of PD patients was
0.712(95% CI：0.652～0.772). The calibration curve also showed a good consistency between the prognostic
Nomogram model and the actual observed values. Conclusion Technical survival was lower in non-diabetic
PD patients with higher serum cystatin C levels before dialysis. The Nomogram incorporating serum cystatin
C has a certain predictive value for the technical survival of PD patients

Key words: Cystatin C, Nomogram, Peritoneal dialysis