无计划/紧急启动与常规启动腹腔透析的比较:系统性审查和元分析
1Department of Nephrology, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China.
Seminars in dialysis
|March 13, 2024
概括
紧急启动腹腔透析 (PD) 在慢性病 (CKD) 患者中显示了类似的感染风险,但与计划的传统启动PD相比,机械并发症和死亡率更高. 精心规划对于PD启动至关重要.
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
- 透析技术 透析技术
背景情况:
- 腹腔透析 (PD) 开始的时间 (传统或紧急开始) 可能会影响慢性病 (CKD) 的结果.
- 紧急开始的PD往往是未计划的,可能与不同的并发症概况有关.
研究的目的:
- 为了比较紧急启动 (非计划) PD与常规启动 (计划) PD在CKD患者中的结果.
- 评估机械并发症,感染,死亡率和转移到血液透析的差异.
主要方法:
- 来自MEDLINE,EMBASE,Cochrane CENTRAL和Scopus数据库的研究的系统审查和元分析 (直到2023年7月).
- 包括27项研究,比较慢性病患者的紧急启动和传统启动PD.
- 对各种结果的95%置信区间 (CI) 的聚合概率比率 (OR) 的分析.
主要成果:
- 传染性并发症 (整体,腹膜炎,出口部位感染) 在紧急开始和传统开始的PD之间是可比的.
- 紧急启动的PD与整体机械并发症 (OR: 1.70) 和泄漏 (OR: 2.47) 的风险显著增加.
- 紧急开始PD的死亡率显著增加 (OR: 1.83);技术存活率和转移到血液透析没有差异.
结论:
- 虽然感染风险相似,但紧急启动的PD在CKD患者中存在明显更高的机械并发症和死亡风险.
- 调查结果强调了在启动PD时仔细规划和仔细考虑的重要性,在可行的情况下偏好传统启动.
- 进一步的研究可能会探索减轻与紧急启动PD相关的风险的策略.
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