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儿童和青少年置换治疗的时间和方式
Julia Thumfart1, Steffen Wagner2, Marietta Kirchner3
1Department of Pediatric Gastroenterology, Nephrology and Metabolic Diseases, Charité Universitätsmedizin, Berlin, Germany.
Kidney international reports
|September 18, 2024
概括
儿童的置换疗法 (KRT) 选择取决于功能下降,疾病类型和患者因素. 特定中心的因素也会影响儿科患者的KRT时间和方式的决定.
科学领域:
- 儿科脏病学 儿科脏病学
- 脏替代疗法治疗 脏替代疗法
- 慢性脏疾病 慢性脏疾病
背景情况:
- 对于患有末期病的儿科患者来说,置换疗法 (KRT) 是至关重要的.
- 关于KRT启动,时间和模式的决定是复杂的,受到多种临床和患者相关因素的影响.
研究的目的:
- 在一个大型的多国儿科队列中分析影响KRT选择和时间的因素.
- 在患有慢性病 (CKD) 的儿童中,确定启动透析与预防性移植的预测因子.
主要方法:
- 在儿童患有CKD (4C) 的心血管并发症研究中对695名患有CKD的儿科患者 (6-17岁) 进行前性调查.
- 竞争风险回归分析以确定临床/实验室参数与KRT启动 (透析或预防性移植) 之间的关联.
主要成果:
- 近一半 (49%) 的患者在8年内开始KRT;200人开始透析,142人接受预防性移植.
- 较低的eGFR,更的eGFR下降,以及更高的静脉血压SDS预测了KRT启动.
- 淋巴细胞病变,较低的BMI SDS和较低的血红蛋白与更高的透析概率有关,而CAKUT与较低的透析概率有关.
结论:
- 功能丧失的速度,初级诊断以及患者的营养和血液状况显著影响儿童的KRT决策.
- 中心特定的因素发挥着作用,突出了儿童KRT管理中标准化方法的需要.
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