腹膜透析在肝硬化中的结果:系统性审查和元分析
Poemlarp Mekraksakit1, Supawadee Suppadungsuk1,2, Charat Thongprayoon1
1Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
概括
腹腔透析 (PD) 在末期脏病 (ESKD) 患者的肝硬化中提供与血液透析 (HD) 相似的死亡结果. 肝硬化不会显著增加PD患者的死亡风险,这表明PD是一种可行的治疗选择.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
背景情况:
- 末期病 (ESKD) 和肝硬化是全球主要的健康问题,死亡率高.
- 血液透析 (HD) 在肝硬化中常见于ESKD,但导致血液动力学不稳定.
- 腹膜透析 (PD) 不常用于肝硬化,因为腹膜炎和死亡率的担忧.
研究的目的:
- 系统地审查和对ESKD肝硬化患者的PD结果进行元分析.
- 为了比较肝硬化患者和非肝硬化患者的PD结果.
- 为了比较患有肝硬化的ESKD患者的PD与HD结局.
主要方法:
- 在Ovid MEDLINE,EMBASE和Cochrane数据库中进行了全面的搜索,截至2023年9月25日.
- 纳入了研究,检查了患有PD或HD肝硬化ESKD患者的死亡率和临床结果.
- 数据是使用随机效应模型和反变量方法进行元分析汇总的.
主要成果:
- 分析包括13项研究,涉及15089名患者.
- 在患有肝硬化的ESKD患者中,在PD和HD之间没有发现死亡率的显著差异 (OR 0.77).
- 患有肝硬化PD的肝硬化患者表现出膜炎 (OR 1.10) 和慢性低血压 (OR 17.50) 的风险较高,但死亡率与非肝硬化对照 (OR 1.05) 相比较.
结论:
- 腹膜透析 (PD) 是一个可行的治疗末期脏病 (ESKD) 在肝硬化患者.
- 在这个人群中,PD提供了与血液透析 (HD) 相似的死亡结果.
- 虽然低血压和腹膜炎等风险略有增加,但PD仍然是一个有效的选择.
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