渐进式与常规性血液透析在末期脏疾病:一个系统的审查和元分析
Kullaya Takkavatakarn1, Kavita Jintanapramote2, Jeerath Phannajit1,3
1Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Clinical kidney journal
|January 8, 2024
概括
渐进性血液透析 (HD) 是安全的,与传统的HD相比,可以减少住院和功能残留的损失. 需要进一步的试验来确认这些好处在选定的患者.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内部医学 内部医学
- 临床试验 临床试验
背景情况:
- 对于从慢性病过渡到末期病的患者,透析处方存在挑战.
- 传统的每周三次血液透析 (HD) 可能会加速残留功能 (RKF) 丧失并增加死亡率.
- 渐进性HD (每周一次或两次) 为传统的HD提供了一个潜在的替代方案.
研究的目的:
- 系统地审查和元分析渐进性HD与传统HD的好处和风险.
- 为了比较包括心血管事件,RKF,血管接入并发症,生活质量,住院和死亡率在内的结果.
主要方法:
- 系统性审查和对比增量和常规HD的研究的元分析.
- 搜索了MEDLINE,Scopus和Cochrane控制试验中央注册表,截至2023年4月.
- 包括36篇文章,共有138,939名参与者.
主要成果:
- 在增量和传统的HD中,死亡率和心血管事件相似.
- 渐进性HD显著减少了住院治疗和RKF的损失.
- 敏感性分析显示,在特定子组中,随着HD的增量,心血管事件和死亡率较低.
- 在血管接入并发症,高胆血症或体积过载方面没有显著差异.
结论:
- 渐进性HD似乎是安全的,并提供潜在的临床益处,特别是在选定的患者.
- 进一步的大规模随机对照试验是必要的,以验证这些发现.
- 渐进性HD可能是管理末期病患者的有益替代方案.
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