Abstract: To investigate the relationship between intraperitoneal pressure (IPP) and early leakage of peritoneal dialysis (PD) in PD patients.  Methods   A total of 60 patients undergoing PD catheterization for first time during October 2020 to September 2021 at the Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University were prospectively analyzed. Their clinical data were collected and then divided into groups according to the IPP after infusion of 2,000ml dialysate and the presence or absence of leakage. Clinical indicators were compared among the groups and correlation analysis was performed.  Results   ①Body weight (F=6.205, P=0.001), body mass index (BMI) (F=16.008, P<0.001), abdominal circumference (F=9.561, P<0.001), body surface area (BSA) (F=4.048, P=0.011), serum creatinine        (K=8.266, P=0.041), blood eosinophil number (K=9.855, P=0.020) and leakage (χ2=17.304, P=0.001) were significantly different among the groups with different IPP (P<0.05). The IPP values at the intraperitoneal dialysate volume (IPV) of 500ml, 1,000ml and 2,000ml were higher in the leakage group than in the non-leakage group (Z=-2.599, 4.216 and -3.025 respectively； P=0.009, <0.001 and =0.002 respectively). The ratio of females was higher in the leakage group than in the non-leakage group (χ2=5.875, P=0.015)； blood eosinophil number was lower in the leakage group (Z=-2.377, P=0.017).  ②Spearman rank correlation analysis showed that IPP was positively correlated with body weight (r=0.479, P<0.001), BMI (r=0.665, P<0.001), BSA(r=0.383, P=0.002), abdominal circumference (r=0.569, P<0.001), IPV (r=0.537, P<0.001), IPV/BMI(r=0.354, P<0.001), IPV/BSA (r=0.436, P<0.001) and leakage (r=0.370, P=0.004), negatively correlated with blood eosinophil number (r=-0.304, P=0.018), and had no correlation with serum creatinine (r=0.082, P=0.539). The presence of leakage was positively correlated with the IPP values at the IPV of 500ml (r=0.338, P=0.008),      1 000mL (r=0.394, P=0.002) and 2 000ml (r=0.394, P=0.002), and negatively correlated with blood eosinophil number(r= -0.309, P=0.016).  ③Logistic regression analysis showed that body weight (OR=2.570, 95% CI: 1.448~4.561, P=0.001), BMI (OR=2.115, 95% CI: 1.415~3.159, P<0.001), abdominal circumference (OR=1.205, 95%  CI: 1.073~1.353, P=0.002) and BSA (OR=1.046, 95% CI: 1.010~1.083, P=0.012) were the independent risk factors for IPP； gender (OR=9.739, 95% CI: 1.134~83.674, P=0.038) and IPP values at the IPV of 500ml (OR=1.535, 95% CI: 1.120~2.104, P=0.008), 1 000ml (OR=1.606, 95% CI: 1.173~2.198, P=0.003) and 2 000ml (OR=1.564, 95% CI: 1.164~2.102, P=0.003) were the independent risk factors for leakage.  Conclusions  Body mass, BMI, abdominal circumference and BSA can be used as the clinical indicators to predict IPP in patients with PD at early stage. In these PD patients, women are more prone to have early leakage than men. IPP is closely related to the early leakage, and the increase of IPP is one of the important factors leading to early leakage.

Key words: Peritoneal dialysis, Intraperitoneal pressure, Early leakage