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慢性功能衰竭死亡风险的流行病学,贡献者和临床试验
Alberto Ortiz1, Adrian Covic2, Danilo Fliser3
1Division of Nephrology, IIS-Fundacion Jimenez Diaz, Madrid, Spain; Department of Medicine, Universidad Autonoma de Madrid, Madrid, Spain; Red de Investigacion Renal (REDINREN), Madrid, Spain; Instituto Reina Sofia de Investigaciones Nefrológicas (IRSIN), Madrid, Spain.
Lancet (London, England)
|May 27, 2014
概括
慢性功能衰竭患者面临高死亡率,特别是在缺乏置换治疗的发展中国家. 解决这一问题需要改善获取,低成本治疗和多方面的护理策略,以减少患者死亡.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 心脏病学 心脏病学
背景情况:
- 慢性功能衰竭 (CKF),定义为膜过率<15mL/min/1.73m2),与高死亡率有关.
- 发展中国家的死亡率在很大程度上是由于缺乏置换疗法 (RRT) 的机会.
- 与普通人群相比,透析或移植后患者的心血管和非心血管死亡率显著增加.
研究的目的:
- 鉴别导致CKF患者死亡率增加的病理生理因素.
- 确定对临床试验设计的心脏脏风险分期系统的需求.
- 提出政策变化和研究方向,以减少CKF的死亡率.
主要方法:
- 对影响衰竭患者死亡率的因素的综述.
- 分析CKF患者与普通人群之间的死亡率差异.
- 识别影响结果的社会经济因素,并发病症和治疗方式.
主要成果:
- 慢性瘤的死亡率是多因素的,受社会经济地位,并发病,RRT模式和功能衰竭严重程度的影响.
- 在CKF患者和普通人群之间存在显著的死亡率差异,特别是在心血管原因方面.
- 目前的RRT接入不足,特别是在发展中国家,导致可预防的死亡.
结论:
- 降低CKF死亡率需要改善获得RRT和开发具有成本效益的治疗选择.
- 多方面的临床护理方法至关重要,同时针对各种致死因素.
- 对风险分层和优化护理途径的进一步研究对于改善患者存活率至关重要.
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