Abstract: Objective  To evaluate the effects of baseline and changes of peritoneal transport characteristics on the prognosis of peritoneal dialysis (PD) patients.  Methods  Patients who started PD in the period from January 1, 2006 to December 30, 2019 and continued PD for more than 3 months in the Department of Nephrology of Nanjing Drum Tower Hospital were included in this study. They were divided into 4 groups according to the baseline dialysate/plasma creatinine (D/Pcr) ratio. Their clinical characteristics, trends of peritoneal transport changes, risk factors for death, and technique failure were analyzed.  Results   A total of 323 PD patients were enrolled in this study, including 70 patients in low transport (L) group, 135 in low average transport (LA) group, 101 in high average transport (HA) group, and 17 in high transport (H) group. Multinomial logistic regression model revealed that male (OR=1.529, 95% CI 1.003~2.330, P=0.049) and low albumin (OR=0.910, 95% CI 0.869~0.952, P＜0.001) were the risk factors for baseline high peritoneal transport status. The survival rate in H group was significantly lower than that in L group (c2=3.953, P=0.047), LA group (c2=4.355, P=0.037) and HA group (c2=9.359, P=0.002). There was no significant difference in technique survival rate among the four groups (c2=0.107, P=0.991). The D/Pcr ratio remained stable in the first 5 years and then presented a slight upward trend. The peritoneal transport status of the four groups had a tendency of centrality with time, i.e., peritoneal transport decreased in higher transport groups and increased in lower transport groups. Multivariate Cox regression analyses showed that age (OR=1.053, 95% CI 1.026~1.082, P＜0.001), Charlson’s comorbidity index (OR=1.630, 95% CI 1.307~2.032, P＜0.001) and baseline high transport (OR=3.280, 95% CI 1.109~9.699, P=0.032) were the independent risk factors for all-cause mortality, and male (OR=1.851, 95% CI 1.123~3.052, P=0.016), C-reactive protein (OR=1.008, 95% CI 1.001~1.015, P=0.025) and peritonitis (OR=2.312, 95% CI 1.430~3.739, P＜0.001) were the independent risk factors for technique failure.  Conclusions  The baseline high peritoneal transport status was an independent risk factors for mortality. Male and low albumin were the determinant factors for baseline high peritoneal transport. The D/Pcr ratio remained stable in the first 5 years and then presented a slight upward trend. The peritoneal transport status of the four groups had a tendency of centrality with time.

Key words: eritoneal dialysis, Prognosis, Peritoneal dialysis characteristics