併存している疾患が腎置換療法での生存に及ぼす影響
Lancet (London, England)
|February 13, 1993
まとめ
腎置換療法 (RRT) を受ける患者の生存率は改善していません. 併発性および年齢によるリスクの階層化は,RRT患者のアウトカムに大きく影響し,個別化された治療戦略の必要性を強調しています.
科学分野:
- ネフロロジーはネフロロジーを用います.
- 臨床流行病学 臨床流行病学とは
- ゲリアトリック・メディシン (老年医学)
背景:
- 腎臓置換療法 (RRT) を受ける患者の生存率は安定しています.
- RRT患者は,ますます,腎臓に関連する健康上の問題 (共病症) 以外の複数の問題を抱える高齢者である.
研究 の 目的:
- RRTを開始した患者の生存傾向を分析する.
- 患者を年齢と併発性に基づいてリスクグループに分類する.
- 異なるリスクグループと地理的センター間の生存率を比較する.
主な方法:
- イギリスのアバーディンとダンディーで,6.5年にわたってRRTを開始した375人の患者を対象とした遡及的研究.
- 患者は,共病性および年齢に基づいて,低リスク,中リスク,および高リスクのグループに分類されました.
- 精算学的生存率を計算し,早期死亡 (90日以内) を含み,含まない分析を行った.
主要な成果:
- リスクグループ全体で2年生存における有意な差異が観察されました (低: 86-90%,中: 60-70%,高: 35-46%).
- 総生存率は61% (アバーディン) と68% (ダンディー) であったが,早期死亡を除外した後にそれぞれ73%と74%に収束した.
- RRTは,低リスクの患者 (70歳未満,併発症なし) で高い成功率 (86%の2年生存率) を示しました.
結論:
- 腎臓置換療法は,低リスクの患者に非常に効果的です.
- 腎臓以外の併発症は,RRTを受けた患者の生存に大きく影響する.
- リスクの階層化と早期死亡の注意深い分析は,RRTセンター間の有効な比較をするために不可欠です.
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