Abstract: 【Abstract】Objective To investigate the clinical characteristics, prognosis and the risk factors for longterm survival in end-stage renal disease patients including end-stage diabetic kidney disease patients treated with automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD). Method This is a retrospective cohort study. Adult peritoneal dialysis patients (peritoneal dialysis over 3 months) from September 1st, 2002 to June 30th, 2018 were enrolled in this study. Their baseline data were collected. These patients were followed up to September 30th, 2018 and death was defined as end point. Survival of APD patients and CAPD patients, diabetic kidney disease (DKD) and non-DKD patients were compared. Univariate and multivariate Cox regression were used to identify the risk factors for long-term prognosis. Results A total of 534 PD patients (92 APD patients and 442 CAPD patients; 198 DKD patients and 336 non-DKD patients) were enrolled in this study. Compared to non-DKD patients, DKD patients were older with a higher ratio of cardiovascular disease. DKD patients started dialysis earlier (creatinine at the time of dialysis: DKD 620.4±228.9 vs. non-DKD 808.0±352.0μmol/L, t=-6.556, P＜0.001). The cumulative survival rate after 1, 3, 5, and 10 years were 92%, 78%, 65% and 42% respectively in APD patients, and were 83%, 65%, 42% and 22%, respectively in CAPD patients. APD patients had longer median survival time (92.3 months vs. 64.3 months, χ2=8.675, P=0.003). DKD patients had shorter median survival time than non-DKD patients (47.9 months vs. 92.3 months, χ2=46.379, P＜0.001), and DKD patients treated with CAPD had the shortest median survival time (45.2 months, χ2=55.545, P＜0.001). Multivariate Cox regression identified that age (β=0.086, HR=1.090, 95% CI 1.039-1.144, P＜0.001), diabetes (β =1.126, HR=3.084, 95% CI 1.157- 8.221, P=0.024) and albumin level (β =- 0.099, HR=0.906, 95% CI 0.836-0.9983, P=0.017) were the risk factors for all-cause mortality in APD patients. Conclusion DKD patients treated with APD showed better long-term survival than those treated with CAPD. However, APD itself may not be the independent impact factor for survival.

Key words: Automated Peritoneal Dialysis, Diabetic Kidney Disease