在希腊裔患有功能衰竭的患者中,根据原产地对结果的差异
Katherine Rizzolo1, Lilia Cervantes2, Holly Wilhalme3
1Section of Nephrology, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, Massachusetts.
Journal of the American Society of Nephrology : JASN
|September 27, 2023
概括
西班牙裔脏患者的家庭透析率不论其出身,都相似,但死亡率和移植率有很大差异. 了解这些差异是为患有功能衰竭的不同西班牙裔人口提供公平护理的关键.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 与非西班牙裔白人患者相比,西班牙裔个人面临更高的功能衰竭风险和更低的移植和家庭透析率.
- 现有研究尚未明确,病的结果和治疗是否在不同的西班牙裔人口中因原产国或领土而有所不同.
研究的目的:
- 为了调查家庭透析使用,死亡率和拉美裔脏衰竭患者的脏移植率的变化,根据其原产地分层.
- 为了确定西班牙裔社区内病结果的差异,以告知有针对性的干预措施.
主要方法:
- 对2009-2017年间开始透析的成人西班牙裔患者的美国脏数据系统 (USRDS) 数据的分析.
- 根据原产国或领土对患者的分类:美国,墨西哥,美国 - 波多黎各和其他国家.
- 使用后勤回归和竞争风险模型来评估家庭透析启动率,死亡率和移植率的差异,并根据相关共变量进行调整.
主要成果:
- 在统计调整后,在美国出生的西班牙裔患者和来自其他国家的患者之间,家庭透析启动率没有显著差异.
- 调整后的死亡风险在来自美国和波多黎各的患者中较高,而在来自墨西哥和其他国家的患者中较低,与美国出生的患者相比.
- 来自墨西哥和美国 - 波多黎各的患者的移植率相似,但与美国出生的患者相比,来自其他国家的患者的移植率更高.
结论:
- 在西班牙裔患者的病死亡率和移植结果中存在显著的异质性,这取决于他们的国家或原产地.
- 在考虑混因素后,在不同西班牙裔子组中,家庭透析的利用似乎相对公平.
- 进一步的研究至关重要,以阐明导致这些观察到的结果差异的潜在机制,并制定公平护理提供策略.
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