为开始透析的患者提供移植教育:差异仍然存在
Vincenzo Villani1, Luca Bertuzzi2, Gabriel Butler3
1Department of Surgery, McGovern Medical School, UT Health Houston, Houston, TX, USA.
Heliyon
|September 16, 2024
概括
15%开始透析的患者没有收到脏移植信息. 了解移植的患者可以更好地访问等待名单和移植,突出显示了持续的差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植 移植 移植 移植
- 医疗保健服务研究 医疗服务研究
背景情况:
- 脏移植是透析患者的重要脏替代疗法选择.
- 之前的研究表明,在向开始透析的患者提供移植信息方面存在差异.
- 了解这些差异对于公平获得移植至关重要.
研究的目的:
- 为了确定患者社会人口统计和透析设施的特征,与在透析开始时没有接收移植信息有关.
- 确定接收移植信息与随后的等待名单和移植结果之间的关联.
主要方法:
- 对医疗保险和医疗补助服务中心 (CMS) 形式2728数据从2007年到2019年的回顾性分析.
- 主要结果:提供在CMS表2728.8.上记录的移植信息.
- 二次结果:使用Cox比例风险模型分析的等待列表添加和移植的时间.
主要成果:
- 15%的患者 (N=133,414) 没有收到移植信息.
- 不知情的患者更有可能是老年人,女性,白人和医疗保险受益者.
- 了解情况的患者从末期病发作到等待名单增加和移植的时间更短.
- 链式透析设施的患者更有可能得到信息,但这并没有增加移植率.
结论:
- 在透析开始时提供移植信息的差异仍然存在.
- 缺乏信息减少了患者获得移植等待名单和实际移植的机会.
- 政策干预应解决设施所有权的差异,以改善移植转诊和结果.
相关概念视频
01:27Dialysis
276
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
276
01:11Renal Failure: Dose Adjustments
68
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
68