相关实验视频
Updated: Jul 27, 2025
07:30
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
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在儿童和年轻成年人中,置换治疗的时间
Nicholas G Larkins1,2, Wai Lim2,3, Carrie Goh1
1Department of Nephrology and Hypertension, Perth Children's Hospital, Nedlands, Western Australia, Australia.
概括
儿科患者正在更早地开始置换疗法 (KRT),特别是那些接受腹腔透析或预防性移植的患者. 这种早期启动的KRT不会影响患者的存活率.
科学领域:
- 儿科脏病学 儿科脏病学
- 脏替代疗法治疗 脏替代疗法
- 流行病学 流行病学
背景情况:
- 没有随机试验指导儿童开始替代疗法 (KRT) 的时间.
- 了解KRT启动的趋势和预测因素对于儿科脏护理至关重要.
研究的目的:
- 确定儿童和年轻成年人KRT启动时估计的球过率 (eGFR) 的趋势和预测因素.
- 评估KRT启动中的与中心相关的临床实践变化.
- 确定在KRT启动时的eGFR与患者存活率之间的关联.
主要方法:
- 来自澳大利亚和新西兰透析和移植注册 (1995-2018) 的数据分析,针对开始KRT的1-25岁患者.
- 量子回归用于估计eGFR与共变量之间的关联.
- 考克斯和后勤回归来评估eGFR对生存的影响,并量化临床实践的变化.
主要成果:
- 在研究期间,KRT开始时的EGFR中位数从7升至9毫升/分钟/1.73平方米.
- 早期的KRT启动在预防性脏移植和腹腔透析中更为明显.
- 在KRT启动时的eGFR与患者存活率之间没有发现任何关联 (HR1.01;95% CI,0.98-1.04).
- 中心变化占KRT启动时间变化的6-10%.
结论:
- 儿童和年轻人在病的早期阶段开始KRT.
- 即使在较早的时候,KRT启动的时间与患者生存率的改善无关.
- 在KRT启动实践中,中心之间存在显著的差异,突出了对标准化护理指南的需求.
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