P1141CT IMAGING FEATURES AND INFLUENCE FACTORS IN PEROTONEAL DIALYSIS RELATED PERITONEAL INJURY

Abstract

Abstract Background and Aims Peritoneal dialysis (PD) is one of the most important renal replacement methods for end-stage renal disease. CT scan found some patients have peritoneal thickening, omental structure change. However, the underlying regularity of change still unknown. This study aim to investigate the regularity of change and influencing factors of CT peritoneal imaging features in PD patients. Method A 173 total routinely follow-up patients on CAPD are evaluated by the abdominal CT scans. A total of 109 patients were enrolled for analysis according to the inclusion criteria. The 109 patients who meet the criteria were evaluated by the semi-quantitative scoring system, including the thickness of the parietal peritoneum, the calcification of parietal peritoneum and omentum, abdominal compartment and encapsulated effusion, bowel dilatation and intestinal obstruction, and the correlation between CT imaging evaluation index and age, dialysis age, primary disease, type of peritoneal transport, glucose exposure, and the incidence of peritonitis were analyzed. Logistic regress was used to analyze the influence factors of peritoneal thickening and abnormal omental structure and the risk incidence of peritoneal thickening and abnormal omental structure. Results 70 patients with parietal peritoneum thickness, 63 patients with abnormal omental structure, 4 patients with the calcification of parietal peritoneum and omentum, 11 patients with abdominal compartment and encapsulated effusion, 24 patients with bowel dilatation and intestinal obstruction. The peritoneal thickening and abnormal omental structure in patients with dialysis age > 5 years was significantly higher than that of age < 1 year. The peritoneal thickening and abnormal omental structure in patients with peritonitis more than once was significantly higher than that in patients without peritonitis. The abnormal omental structure in patients with total glucose exposure > 165kg was significantly higher than that with total glucose exposure <60 kg. The abnormal omental structure in patients with high-average peritoneal transport was significantly higher than that with low-average peritoneal transport. The risk factors of abnormal omental structure including dialysis age, the peritonitis occurrences, the cumulative score of peritonitis, the total glucose exposure, and the high-average peritoneal transport. The independent risk factors are the occurrence and the cumulative score of peritonitis. The incidence risk of peritoneal thickening and abnormal omental structure will increase 4.364 and 5.393 times separately with the occurrence of peritonitis, and increase 2.191 and 2.072 times separately with the cumulative score of peritonitis increased by 1 point. Conclusion The main imaging features of peritoneal dialysis patients with progressive peritoneal injury are thickness of the parietal peritoneum and the structure change of omentum. The major risk factor of progressive peritoneal injury is peritonitis. The abdominal CT scan can comprehensively investigate the characteristics and extent of peritoneal dialysis and injury, which is benefit for the early diagnosis of peritoneal injury.