在接受维持透析治疗的成年人中,感染相关死亡率的长期趋势
Chanel H Chong1, Eric H Au2, Christopher E Davies3
1School of Public Health, University of Sydney, Sydney; Centre for Kidney Research, the Children's Hospital at Westmead, Sydney.
概括
透析患者的感染相关死亡人数有显著下降,但仍然是普通人群的20倍以上. 这项研究分析了澳大利亚和新西兰透析患者感染死亡率的趋势和危险因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 感染是接受维持透析的患者死亡的主要原因.
- 了解感染相关死亡的时间趋势和风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 从1980年到2018年,评估澳大利亚和新西兰透析患者感染相关死亡率的趋势.
- 为了确定与感染相关死亡相关的风险因素在这个人群中.
主要方法:
- 追溯队列研究,包括在1980年至2018年期间开始透析的成年人.
- 分析感染相关死亡的发病率和标准化死亡率 (SMR).
- 使用了细灰分发危险模型,考虑了竞争风险.
主要成果:
- 该研究包括46,074名血液透析和20,653名腹腔透析患者.
- 总体上,每1万人/年感染相关死亡率为185 (血液透析) 和232 (腹腔透析).
- 与感染相关的死亡率与女性性别,年龄较大和土著身份 (原住民和/或托雷斯海峡岛民或毛利) 有关.
结论:
- 虽然随着时间的推移,与感染相关的死亡风险有了显著的改善,但与普通人群相比,它仍然大幅增加.
- 需要进一步研究感染类型和死亡率之间的因果关系,尽管在本研究中无法进行数据分类.
相关概念视频
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
46
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
46
Dialysis
390
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
390
Hemodialysis III: Nursing Management
50
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
50
Acute Kidney Injury IV: Diagnostic Studies and Prevention
40
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
40
Hemodialysis II: Procedure and Complications
42
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
42
Chronic Kidney Disease III: Interprofessional Care
50
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
50


