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腹膜透析技术生存率:一个队列研究

Caroline M Hsu¹, Nien Chen Li², Eduardo K Lacson³

¹Tufts Medical Center, Boston, Massachusetts.

American journal of kidney diseases : the official journal of the National Kidney Foundation

|April 19, 2024

概括

首先开始腹腔透析 (PD) 与更长的PD技术存活率有关. 腹膜炎和低白蛋白等因素增加了切换为血液透析 (HD) 的风险.

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
透析方式透析方式

背景情况:

腹腔透析 (PD) 与血液透析 (HD) 相比具有优势,但有相当数量的患者过早转移到HD.
了解影响PD技术生存的因素对于优化患者护理至关重要.

研究的目的:

评估临床因素的关联,包括先前的血液透析 (HD) 治疗,与腹腔透析 (PD) 技术的存活率.
确定从PD转移到HD的风险因素.

主要方法:

在2010年至2019年期间,对5224名发病于PD的成年患者进行了回顾性队列研究.
分析对PD发病时间进行了分类:PD-first,PD-early (在90天内从HD转为PD),PD-late (90天后从HD转为PD).
使用具有竞争风险和时间变化的协变量的多变量细灰色模型.

主要成果:

晚些时候开始PD的患者 (PD-早期和PD-晚期) 与PD-第一患者相比,转移到HD的风险明显更高.
患PD转移到HD的危险因素包括更多的腹膜炎发作,更少的家庭访问,较低的血清白蛋白,减少的残留功能,以及较低的每周Kt/V.
28%的患者 (1,472) 在研究期间从PD转移到HD.

结论:

与PD启动透析与PD技术生存率的改善有关.
周周炎,低血清白蛋白和低周周清除率 (Kt/V) 是PD转移到HD的可修改风险因素.
需要进一步的研究来解决关于透析充分性和残留功能缺失的数据.

关键词:

最终阶段的脏疾病.最终阶段的脏疾病.在家进行透析.腹膜透析是指腹膜透析.

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