对影响末期病患者死亡率的实验室值的评估:竞争风险的方法
Rayka Malek1, Ahmadreza Baghestani2, Farin Rashid-Farokhi3
1School of Population Health sciences, King's College London, London, UK.
BMC nephrology
|July 18, 2023
概括
男性性别,高血清和高副甲状腺激素水平与接受血液透析 (HD) 的患者的生存率较差有关. 解决这些因素可能会改善慢性病 (CKD) 患者的治疗结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 生物统计学 生物统计学
背景情况:
- 慢性病 (CKD) 是一个日益严重的全球健康问题.
- 在血液透析 (HD) 上的末期病 (ESRD) 患者面临着重大的生存挑战.
- 了解影响ESRD患者生存的因素对于改善护理至关重要.
研究的目的:
- 调查伊朗ESRD患者在HD生存的人口和实验室预测因素.
- 评估特定参数对死亡率和移植率的影响.
- 在现实世界临床环境中应用先进的统计建模来进行生存分析.
主要方法:
- 分析了一组109名在伊朗 (2014-2018) 接受慢性HD患者的队列.
- 两个参数的韦布尔分布和贝叶斯方法模拟了死亡和移植的时间 (竞争风险).
- 评估了人口统计数据和血清中和完整的副甲状腺激素 (iPTH) 的水平.
主要成果:
- 男性性别,血清>9.5 mg/dL,IPTH>150 pg/mL与增加的死亡风险显著相关.
- 在HD的前两年,累计的死亡率超过了移植.
- 4年累计发病率为63.7%的死亡和36.3%的移植.
结论:
- 男性性别,高血和缺甲状腺症是HD患者的不良预后因素.
- 纠正这些实验室异常可能会提高ESRD人群的生存率.
- 这项研究强调了改善血液透析患者长期结果的关键可修改因素.
相关概念视频
Factors Affecting Renal Clearance: Renal Impairment
119
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
119
Comparing the Survival Analysis of Two or More Groups
226
Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
226
Kaplan-Meier Approach
183
The Kaplan-Meier estimator is a non-parametric method used to estimate the survival function from time-to-event data. In medical research, it is frequently employed to measure the proportion of patients surviving for a certain period after treatment. This estimator is fundamental in analyzing time-to-event data, making it indispensable in clinical trials, epidemiological studies, and reliability engineering. By estimating survival probabilities, researchers can evaluate treatment effectiveness,...
183
Chronic Kidney Disease III: Interprofessional Care
43
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...
43
Acute Kidney Injury IV: Diagnostic Studies and Prevention
36
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...
36
Renal Failure: Dose Adjustments
122
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
122


