腹腔透析和血液透析的老年ESKD患者之间的临床结果:一项国家队列研究
Yu-Kai Peng1,2, Tzong-Shyuan Tai1, Chao-Yi Wu2,3,4
1Division of Nephrology, Nephrology Department, Kidney Research Center, Linkou Medical Center, Kidney Research Institute, Chang Gung Memorial Hospital, No.5, Fuxing Street, Guishan District, Taoyuan City, 33305, Taiwan.
Scientific reports
|September 27, 2023
概括
在腹腔透析 (PD) 上的末期病 (ESKD) 的老年患者心脏事件和癌症比血液透析 (HD) 上的患者少. 然而,PD患者经历了更多的感染,两种治疗方法的死亡率相似.
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
- 公共卫生 公共卫生
背景情况:
- 人口老龄化正在增加末期病 (ESKD) 的发生率.
- 老年ESKD患者的移植选择有限,因此透析方式的选择至关重要.
- 腹腔透析 (PD) 和血液透析 (HD) 是老年人的主要置换疗法.
研究的目的:
- 为了比较接受PD和HD的老年ESKD患者的临床结果.
- 在老年人群中为置换疗法提供临床决策的信息.
主要方法:
- 在2013-2019年间诊断出ESKD的36852名老年患者 (≥65岁) 的回顾性分析.
- 根据长期治疗,患者被分为PD和HD组.
- 倾向性得分匹配被用来平衡群体之间的基线特征.
主要成果:
- 与HD组 (n=1628) 相比,PD组 (n=1628) 的重大心脏和脑血管不良事件 (MACCE) (10.09%对13.03%) 和恶性病 (1.23%对2.14%) 的发生率显著降低 (n=6512).
- 在PD组中,MACCE相关的死亡率也较低 (1.35%对2.25%).
- 病发症组的感染发病率较高 (34.09%vs24.14%),但所有原因和感染相关死亡率在各组之间没有差异.
结论:
- 与血液透析相比,腹膜透析可能为老年ESKD患者提供心血管和瘤方面的好处.
- 患有PD的感染风险增加需要在这个人群中进行谨慎的管理.
- 该研究提供了有价值的数据,以指导老年ESKD患者在PD和HD之间做出选择.
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