Clinical uremic syndrome scores and mortality in peritoneal dialysis: a multi-center retrospective study

Abstract No study has comprehensively investigated the association between comorbidities, uremic-specific complications (collectively defined as clinical uremic syndrome [CUS]), and mortality in peritoneal dialysis (PD) patients. We conducted a retrospective cohort study including 4,424 incident PD...

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Main Authors: Xianfeng Wu, Wenjun Lin, Jinyuan Zhao, Na Tian, Qingdong Xu, Yueqiang Wen, Xiaojiang Zhan, Fenfen Peng, Xiaoyang Wang, Ning Su, Xiaoran Feng, Niansong Wang, Juan Wu
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-15473-z
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author Xianfeng Wu
Wenjun Lin
Jinyuan Zhao
Na Tian
Qingdong Xu
Yueqiang Wen
Xiaojiang Zhan
Fenfen Peng
Xiaoyang Wang
Ning Su
Xiaoran Feng
Niansong Wang
Juan Wu
author_facet Xianfeng Wu
Wenjun Lin
Jinyuan Zhao
Na Tian
Qingdong Xu
Yueqiang Wen
Xiaojiang Zhan
Fenfen Peng
Xiaoyang Wang
Ning Su
Xiaoran Feng
Niansong Wang
Juan Wu
author_sort Xianfeng Wu
collection DOAJ
description Abstract No study has comprehensively investigated the association between comorbidities, uremic-specific complications (collectively defined as clinical uremic syndrome [CUS]), and mortality in peritoneal dialysis (PD) patients. We conducted a retrospective cohort study including 4,424 incident PD patients from seven centers in China. Comorbidities and complications were each assigned one point: cardiovascular disease, peripheral vascular disease, cerebrovascular disease, diabetes mellitus, hypertension, hyperlipidemia, malnutrition, and anemia. Patients aged 50 years or older received additional points. The total score (CUS score) was calculated to evaluate its association with mortality in PD patients. Over 18,898.4 person-years of follow-up, 1,208 patients (27.3%) died. The median CUS score was 3 (interquartile range [IQR] 2–5; range, 1–11). A nonlinear association between CUS scores and all-cause mortality was observed (nonlinear, p = 0.006). A pre-1point increase in the CUS score was associated with a 1.35-fold increase in the risk of all-cause mortality (95% confidence interval [CI], 1.31–1.39). Compared with patients with CUS scores ≤ 3, those with scores > 3 had a 2.81-fold higher risk of mortality (95% CI, 2.47–3.21). Higher CUS scores were significantly associated with increased all-cause mortality risk in PD patients, particularly those with scores > 3.
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spelling doaj-art-e4b8008b781a4d5da07baad03d2491192025-08-20T03:04:31ZengNature PortfolioScientific Reports2045-23222025-08-011511810.1038/s41598-025-15473-zClinical uremic syndrome scores and mortality in peritoneal dialysis: a multi-center retrospective studyXianfeng Wu0Wenjun Lin1Jinyuan Zhao2Na Tian3Qingdong Xu4Yueqiang Wen5Xiaojiang Zhan6Fenfen Peng7Xiaoyang Wang8Ning Su9Xiaoran Feng10Niansong Wang11Juan Wu12Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Nephrology, Shanghai Eighth People’s HospitalDepartment of Nephrology, General Hospital of Ningxia Medical UniversityDepartment of Nephrology, Jiangmen Central HospitalDepartment of Nephrology, the Second Affiliated Hospital of Guangzhou Medical UniversityDepartment of Nephrology, the First Affiliated Hospital of Nanchang UniversityDepartment of Nephrology, Zhujiang Hospital of Southern Medical UniversityDepartment of Nephrology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Hematology, The Sixth Affiliated Hospital of Sun Yat-Sen UniversityDepartment of NephrologyDepartment of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical CollegeAbstract No study has comprehensively investigated the association between comorbidities, uremic-specific complications (collectively defined as clinical uremic syndrome [CUS]), and mortality in peritoneal dialysis (PD) patients. We conducted a retrospective cohort study including 4,424 incident PD patients from seven centers in China. Comorbidities and complications were each assigned one point: cardiovascular disease, peripheral vascular disease, cerebrovascular disease, diabetes mellitus, hypertension, hyperlipidemia, malnutrition, and anemia. Patients aged 50 years or older received additional points. The total score (CUS score) was calculated to evaluate its association with mortality in PD patients. Over 18,898.4 person-years of follow-up, 1,208 patients (27.3%) died. The median CUS score was 3 (interquartile range [IQR] 2–5; range, 1–11). A nonlinear association between CUS scores and all-cause mortality was observed (nonlinear, p = 0.006). A pre-1point increase in the CUS score was associated with a 1.35-fold increase in the risk of all-cause mortality (95% confidence interval [CI], 1.31–1.39). Compared with patients with CUS scores ≤ 3, those with scores > 3 had a 2.81-fold higher risk of mortality (95% CI, 2.47–3.21). Higher CUS scores were significantly associated with increased all-cause mortality risk in PD patients, particularly those with scores > 3.https://doi.org/10.1038/s41598-025-15473-z
spellingShingle Xianfeng Wu
Wenjun Lin
Jinyuan Zhao
Na Tian
Qingdong Xu
Yueqiang Wen
Xiaojiang Zhan
Fenfen Peng
Xiaoyang Wang
Ning Su
Xiaoran Feng
Niansong Wang
Juan Wu
Clinical uremic syndrome scores and mortality in peritoneal dialysis: a multi-center retrospective study
Scientific Reports
title Clinical uremic syndrome scores and mortality in peritoneal dialysis: a multi-center retrospective study
title_full Clinical uremic syndrome scores and mortality in peritoneal dialysis: a multi-center retrospective study
title_fullStr Clinical uremic syndrome scores and mortality in peritoneal dialysis: a multi-center retrospective study
title_full_unstemmed Clinical uremic syndrome scores and mortality in peritoneal dialysis: a multi-center retrospective study
title_short Clinical uremic syndrome scores and mortality in peritoneal dialysis: a multi-center retrospective study
title_sort clinical uremic syndrome scores and mortality in peritoneal dialysis a multi center retrospective study
url https://doi.org/10.1038/s41598-025-15473-z
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