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患有慢性脏病的八分生儿在脏病诊所:进展者与非进展者
Aida Frías1, Francisco Vargas1, Justo Sandino1
1Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain.
Frontiers in nephrology
|September 7, 2023
概括
80岁以上的老年患者在转诊时功能稳定,通常保持这种稳定性. 这些人可能不需要科评估,优化医疗保健资源分配.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 内部医学 内部医学
背景情况:
- 目前慢性病 (CKD) 的定义导致老年患者 (≥80岁) 转诊科的情况增加.
- 并非所有老年慢性病患者都可能受益于专家病学评估.
- 这项研究调查了老年患者的临床过程,这些老年患者被转到科.
研究的目的:
- 为了分析80岁及以上的患者功能演变的情况,转移到科.
- 确定影响老年人CKD进展的因素.
- 为了确定脏病学转诊是否有益于所有老年患者,估计膜过率 (eGFR) 降低.
主要方法:
- 一个单一中心的回顾性和前性研究包括318名80岁以上的患者,其eGFR<60mL/min/1.73m2.
- 患者被分为进展者 (>5mL/min/1.73m2年EGFR损失) 和非进展者 (≤5mL/min/1.73m2).
- 临床和分析数据是在访问前12个月,在基线,以及访问后12个月和24个月收集的.
主要成果:
- 在基线时,55.7%的患者被归类为进展者.
- 进步者的比例在12个月后降至26.3%,在24个月后降至13.4%.
- 白蛋白尿是进展的主要风险因素;初始非进展者没有观察到科干预的显著影响.
结论:
- 在科转诊时,功能稳定的老年患者在24个月内倾向于保持稳定的功能.
- 对于所有患有稳定的CKD的老年患者,可能不需要转诊脏病学.
- 这一发现表明,在老年科中优化专家转诊途径的潜力.
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