初始透析方式对ESRD患者生存的影响:一种倾向性与得分匹配的研究
1Department of Nephrology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, 3rd Kangxin Road, Zhongshan, 528400, China.
BMC nephrology
|October 26, 2023
概括
在末期病 (ESRD) 患者中,血液透析 (HD) 和腹腔透析 (PD) 的生存结果总体上相似. 然而,PD在糖尿病ESRD患者中显示出更高的生存率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 脏替代疗法治疗 脏替代疗法
- 临床流行病学临床流行病学
背景情况:
- 在末期病 (ESRD) 患者中,血液透析 (HD) 和腹腔透析 (PD) 之间的生存比较仍然存在争议.
- 这项研究旨在澄清初始透析方式对患者存活率的影响,使用匹配对队列设计.
研究的目的:
- 为了比较末期病 (ESRD) 患者的存活率,开始治疗血液透析 (HD) 与腹腔透析 (PD).
- 为了确定ESRD患者进行透析时与死亡相关的风险因素.
- 调查HD和PD之间的潜在生存差异,特别是在糖尿病患者的小组中.
主要方法:
- 一项回顾性队列研究包括了ESRD患者,他们在2010年至2018年期间开始置换疗法.
- 倾向性得分匹配用于平衡HD和PD组之间的基线特征.
- 使用多变量考克斯回归和卡普兰-梅尔分析来比较死亡率和生存结果,并对糖尿病状况进行亚组分析.
主要成果:
- 在125个匹配对中,HD和PD的整体1年,2年和3年生存率都很高,在整体倾向性得分匹配队列中没有显著差异 (日志排名P = 0.514).
- 开始时的年龄,查尔森并发症指数 (CCI),充血性心力衰竭和脑血管疾病被确定为死亡风险因素.
- 在糖尿病ESRD患者的小组中,腹腔透析 (PD) 与血液透析 (HD) 相比显示出明显更好的生存率 (日志排名P = 0.022).
结论:
- 最初的透析方式 (HD与PD) 在这个ESRD队列中没有显著影响患者的整体存活率.
- 腹腔透析 (PD) 与改善的生存结果有关,特别是在糖尿病末期病患者中.
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