腹膜透析和家庭血液透析患者的严重感染:一项初始队列研究
Wisam Bitar1, Jaakko Helve1,2, Mari Kanerva3
1Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
PloS one
|June 14, 2023
概括
腹腔透析 (PD) 患者,包括持续的门诊PD (CAPD) 和自动化PD (APD),与家庭血液透析 (HD) 相比,面临更高的严重感染风险. 这种增加的风险主要是由于PD相关的周周炎.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 传染性疾病 传染性疾病
- 透析治疗 透析治疗
背景情况:
- 感染是透析患者的主要死亡原因.
- 之前的研究表明,腹膜透析 (PD) 与血液透析 (HD) 的感染风险更高,但对家庭HD的数据有限.
研究的目的:
- 为了比较持续的门诊PD (CAPD) 和自动PD (APD) 患者与家庭HD的严重感染风险.
- 确定不同透析方式中感染风险的主要驱动因素.
主要方法:
- 对536名在家透析的成年患者进行了回顾性队列研究.
- 严重的感染定义为C-反应蛋白≥100 mg/l.
- 分析包括累积发病率,竞争性风险和倾向性得分调整后的考克斯回归.
主要成果:
- 一年内严重感染的风险:35% (CAPD),25% (APD),11% (家庭HD).
- 严重感染的五年危险比:2.8 (CAPD) 和2.2 (APD) 与家庭HD相比.
- 每 1000 个患者年发生率:537 (CAPD),371 (APD),197 (家庭HD).
结论:
- 与家庭的HD相比,CAPD和APD都与严重感染的风险明显更高.
- 与PD相关的腹膜炎是PD患者感染风险增加的主要原因.
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