在腹膜透析的老年患者中,增量腹膜透析的可行性
Ruihua Liu1,2, Jing Guo1,2, Hongjian Ye1,2
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Kidney research and clinical practice
|August 10, 2023
概括
老年患者的渐进性腹膜透析 (iPD) 显示了更好的功能维护和存活率. 这种方法还可以降低腹膜炎的风险,这表明iPD是老年人可行的选择.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 老年病的医生 老年病的医生
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 腹腔透析 (PD) 是一种关键的置换疗法.
- 老年患者代表着越来越多的PD患者.
- 对于老年患者来说,最佳的PD疗法需要进行调查.
研究的目的:
- 评估60岁及以上患者增量腹膜透析 (iPD) 的可行性和结果.
- 为了在这个人群中比较iPD与标准全剂量PD.
主要方法:
- 从2008年至2017年,对238名PD患者 (≥60岁) 的回顾性队列研究.
- 患者分为IPD (≤3次/天) 和全剂量PD (≥4次/天).
- 卡普兰-梅尔曲线和考克斯回归分析了无尿症和死亡风险.
主要成果:
- 与全剂量组 (186名患者) 相比,iPD组 (52名患者) 的无尿风险 (HR 0.44) 和全因死亡率 (HR 0.59) 显著降低 (HR 0.44).
- 腹膜炎的发病率在IPD组 (0.115次/人/年) 与全剂量组 (0.197次/人/年) 相比显著较低.
- 平均年龄为67.8岁,女性为45.8%,基线GFR为4.15毫升/分钟/1.73米2.
结论:
- 在老年患者中,增量腹膜透析独立地与更好的残留功能保存有关.
- iPD与改善生存结果和降低老年PD患者腹膜炎发病率有关.
- 对于需要腹腔透析的老年人来说,iPD策略提出了一个潜在的可行和有益的治疗选择.
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