欧州における過去10年間の家庭内透析の動向: ERAの登録調査
Maria Fernanda Slon-Roblero1, Vianda S Stel2,3, Emilio Sanchez-Alvarez4
1Department of Nephrology, Hospital Universitario de Navarra, Pamplona, Spain.
まとめ
家庭用血液透析 (HHD) の使用は増加し,腹膜透析 (PD) の使用は2012年から2021年にかけて減少した. 家庭内透析の普及率は依然として低いため,患者の腎臓置換治療へのアクセスを増やすための戦略の改善が必要であることを示している.
科学分野:
- 腎臓科と泌尿器科
- 公衆衛生
- 医療サービス研究
背景:
- 家庭用血液透析 (HHD) と腹腔透析 (PD) を含む家庭用透析療法では,透析を必要とする患者にとって潜在的な利点があります.
- 腎臓置換療法 (KRT) の戦略を最適化するために,家庭内透析の傾向と治療法間の移行を理解することは極めて重要です.
研究 の 目的:
- 2012年から2021年までのヨーロッパ諸国におけるHHDとPDの発症と流行の傾向を調べる.
- 病院内でのHDと腎臓移植を含む,自宅での透析方法と他のKRTの間の患者の移行を評価する.
主な方法:
- 欧州腎臓協会 (ERA) レジストリから得られた13のヨーロッパの成人のKRT患者のデータ分析.
- 家庭内透析の開始率,年間流行率,およびHHDまたはPDの開始前のおよび後の移行の評価
主要な成果:
- 2012年から2021年の間に,HHDの発症と発症率は増加し,PDの発症と発症率は減少し,全般的な家庭内透析率は安定しました.
- 家庭内透析はKRTの総発生率の5. 8%を占め,ほとんどのHHD患者はセンター内でのHDから移行したが,ほとんどのPD患者はKRTを未経験であった.
- 治療開始から2年後,HHD患者のアウトカムには53. 2%がHHDに残り,20. 9%が腎臓移植を受け,16. 6%がセンター内HDに移行した. PD患者のアウトカムには,PDの残留39. 6%,センター内HDへの移行22. 6%,腎臓移植を受けた18. 3%が含まれています.
結論:
- HHDの使用が増加したにもかかわらず,PDの使用は減少しており,両方の形態の総有病率は低いままです.
- 他のKRTから家庭内透析や家庭内透析のやり方への移行は限られている.
- 患者にとって有益な家庭内透析療法へのアクセスを強化するために,地域特有の戦略を策定し,実施する必要があることは明らかです.
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