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对腹膜透析结果的洞察:使用竞争风险分析的方法
Ana Cunha1, Beatriz Gil Braga1, Sofia Sousa2
1Department of Nephrology, Centro Hospitalar Universitário de Santo António, Unidade Local de Saúde de Santo António, Porto, Portugal.
Seminars in dialysis
|April 15, 2025
概括
腹膜透析 (PD) 患者的主要风险是过渡到血液透析 (HD),这不受基线特征的影响. 选择PD-first积极影响移植 (KT) 获得,并保持低死亡率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床流行病学临床流行病学
背景情况:
- 腹腔透析 (PD) 的结果是复杂的,因为结果各不相同.
- 分析PD患者的结果需要了解影响死亡率的因素,过渡到血液透析 (HD) 和移植 (KT).
研究的目的:
- 评估PD患者的死亡率,HD转移率和KT率.
- 为了确定影响这些PD结果的基线患者特征.
主要方法:
- 观察性,回顾性,基于注册的,单中心的队列研究.
- 包括722例发生的成人PD患者 (1985-2022年).
- 使用竞争风险分析 (累积发病率函数,精细和灰色模型).
主要成果:
- 60个月的最高概率是转移到HD (0.38),其次是KT (0.27) 和死亡 (0.19).
- 糖尿病与死亡率增加相关 (HR 1.71).
- 首先使用PD的方法降低了HD转移风险 (HR 0.76),并增加了KT的可能性 (HR 1.73).
- 血管通道作为PD原因与较高的死亡率相关 (HR 2.16).
结论:
- 过渡到HD是PD患者的主要风险,独立于基线因素.
- 一个PD-first策略增强了KT的获取,并确保了低,不受影响的死亡率,证实了PD的安全性.
- 血管接入驱动的PD启动与死亡率增加有关,可能是由于并发症.
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