Abstract: Objective  To investigate the changes in peritoneal transport function and its influence on cardiovascular events (CVE) in peritoneal dialysis (PD) patients.  Method  A total of 114 patients who started PD in the Second Hospital of Anhui Medical University from 1 January 2014 to 31 December 2019 were involved and followed until the occurrence of CVE, change to hemodialysis or kidney transplantation, loss to follow-up, death, or till the study termination date (31 December 2021). According to the changes in dialysate to plasma ratio of creatinine at 4h(4hD/Pcr), all participants were divided into increased (n=70) or decreased (n=44) groups. Compared the occurrence of CVE between the two groups and used the COX regression to explore the influencing factors of CVE in PD patients.  Results  In patients with baseline peritoneal transport functions were low transporters, 4hD/Pcr tended to increase in the first two years, low average transporters increased in the first year, and both high and high average transporters showed a decreasing trend in the first two years. The patients in increased group were significantly younger than the decreased group (t=2.396, P=0.018). A total of 44 (38.6%) patients developed CVE during a mean follow-up of 40.5 months. Among them, 22 (31.4%) were in the increase group and 22 (50%) were in the decrease group. The cumulative proportion of CVE-free in the increased group was higher than that in the decreased group (χ2=4.000, P=0.046). Multivariate Cox regression analysis showed that the changes in 4hD/Pcr (HR=0.093, 95%CI: 0.013～0.662, P=0.018) and diabetes mellitus (HR=2.824, 95%CI: 1.441～5.535, P=0.002) were independent influencing factors for the occurrence of CVE in PD patients. Conclusion   PD patients with decreased 4hD/Pcr have a high risk of CVE. 

Key words: Peritoneal dialysis, Peritoneal transport function, Dialysate to plasma ratio of creatinine at 4 hours, Cardiovascular events