慢性病患者的透析过渡模式 心脏衰竭和没有心脏衰竭的患者
Mitchell E Flagg1, Simran K Bhandari2, Katherine J Pak3
1Department of Internal Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA.
Mayo Clinic proceedings
|February 19, 2025
概括
患有慢性病 (CKD) 和心力衰竭 (HF) 的患者经历了低于最佳的透析启动,包括更多的住院开始和中央静脉导管使用. 这些发现表明,需要为患有HF的CKD患者量身定制的治疗策略.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 慢性病 (CKD) 和心力衰竭 (HF) 是常见的并发症.
- 对于慢性病患者,过渡到维持透析需要谨慎管理.
- 心力衰竭影响CKD进展和透析启动模式.
研究的目的:
- 为了比较CKD患者与无HF患者之间的透析过渡模式.
- 调查住院透析启动,透析启动eGFR和中央静脉导管 (CVC) 使用的差异.
- 为了确定治疗慢性病患者的潜在差异,并发性HF.
主要方法:
- 2007-2018年间开始维持透析的CKD患者的横截面研究.
- 患者根据心力衰竭的存在和类型进行了分类.
- 波桑回归被用来评估HF和透析启动/访问模式之间的关联.
主要成果:
- 在6812名开始透析的CKD患者中,有37%患有HF.
- 患有HF的患者的住院透析率 (18.5%与9.6%) 和CVC使用率 (58.5%与51.9%) 较高.
- 患有HF的CKD患者在更高的平均eGFR (11.3比9.4毫升/分钟/1.73米2) 开始透析.
结论:
- 患有HF的CKD患者表现出较高的亚最佳透析启动率.
- 这些包括更频繁的住院透析开始和中央静脉导管安置.
- 研究结果强调,需要针对临近透析的HF慢性病患者制定独特的治疗策略.
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