在COVID-19大流行期间腹膜透析在发展中国家是有效的治疗方法:墨西哥的一份报告
Alberto Villa-Torres1, Enzo Vásquez-Jiménez2, Ricardo Iván Velazquez-Silva2,3
1Department of Nephrology, Centro Medico ISSEMYM, Toluca, Mexico.
Blood purification
|October 25, 2023
概括
腹腔透析 (PD) 在COVID-19大流行期间作为一种可行的替代疗法,特别是在资源有限的环境中. 然而,急性损伤患者的PD显示出更高的死亡率,高SOFA得分和机械通风是关键风险因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 由于COVID-19大流行使脏替代疗法 (RRT) 的资源受到压力,因此需要探索替代疗法.
- 腹腔透析 (PD) 在疫情高峰期间被评估为墨西哥一家三级护理中心的关键RRT选择.
- 这项研究重点关注慢性PD患者和需要急性PD的损伤患者的结果.
研究的目的:
- 在COVID-19大流行期间报告慢性和急性腹膜透析 (PD) 患者的结果.
- 在全球卫生危机期间,评估PD作为脏替代疗法的有效性和挑战,在资源有限的环境中.
主要方法:
- 采用了一种描述性,纵向性,观察性和回顾性研究设计.
- 该研究包括47名在COVID-19流行病的第一波和第二波期间患有非典型肺炎的成年患者.
- 患者包括慢性PD使用者和由于急性损伤 (AKI) 新开始PD的患者.
主要成果:
- 研究队列包括47名患者 (29例慢性PD,18例AKI的PD),平均年龄为59岁;63.8%是男性.
- 总体死亡率高达61.7%,慢性PD患者的死亡率为55.2%,患有AKI的偶发PD患者的死亡率为72.2%.
- 死亡率的预测因素包括较高的顺序器官衰竭评估 (SOFA) 评分,机械通风的需要和血管压缩剂的使用 (p < 0.01).
结论:
- 腹腔透析 (PD) 在COVID-19大流行期间被证明是低收入和中低收入国家可行的RRT替代方案.
- 在AKI患者中,PD有效地控制了高卡利米亚,酸性化,尿血和体积过载,尽管该组的死亡率较高.
- 高SOFA分数,侵入性机械通风和血管压缩器的要求被确定为死亡的重要风险因素.
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