过渡性血液透析与腹膜透析期间出血风险之间的关联
A Young Kim1, Kyu Hyang Cho1, Jong Won Park1
1Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea.
Journal of clinical medicine
|December 17, 2024
概括
在腹膜透析导管插入前进行临时血液透析并没有降低出血风险,也没有改善尿路出血风险患者的导管存活率. 血小板计数,血红蛋白和国际正常化比率是影响出血并发症的关键因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血管接入手术 血管接入手术
背景情况:
- 腹腔透析 (PD) 导管插入具有严重出血的低风险.
- 周运管出血可能导致导管相关的感染,并降低导管存活率.
- 识别出血的危险因素对于改善PD结果至关重要.
研究的目的:
- 分析PD导管插入期间出血并发症的风险因素.
- 评估临时预防性血液透析对出血和导管存活率的影响.
主要方法:
- 对336名接受PD导管插入的患者进行了回顾性分析.
- 在有或没有预防性血液透析的患者之间比较出血并发症和导管存活率.
- 考克斯回归分析以确定出血和导管存活的风险因素.
主要成果:
- 临时血液透析与减少出血没有显著的关联 (HR:1.6,p=0.134).
- 较低的血小板计数 (HR:0.99,p=0.048) 和血红蛋白 (HR:0.78,p=0.04) 与出血相反相关.
- 较高的国际正常化比率 (HR:2.24,p=0.012) 与出血有积极的关联.
- 临时血液透析没有显著影响导管存活率 (HR: 1.64,p=0.308).
结论:
- 在插入PD导管之前的预防性血液透析不能显著减轻容易发生尿路出血的患者的出血风险.
- 血小板计数,血红蛋白和INR是出血并发症的重要预测因素.
- 进一步的研究可能会探索在这个人群中管理出血风险的其他策略.
相关概念视频
01:27Dialysis
261
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...
261
01:24Disorders of Hemostasis
699
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
699
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
608
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
608