腹膜透析患者的长期死亡率和技术存活率:在单个中心进行25年后期分析
Roberta Scarmignan1, Gaetano Alfano2, Niccolò Morisi1
1Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine (CHIMOMO), Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy.
Clinical kidney journal
|August 5, 2025
概括
这项研究表明,虽然腹膜透析 (PD) 的使用增加了,但连续的门诊腹膜透析 (CAPD) 与死亡率更高有关. 然而,PD解决方案和远程监测的进步在25年内改善了患者的治疗结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 脏替代疗法治疗 脏替代疗法
- 透析技术 透析技术
背景情况:
- 在腹腔透析 (PD) 单位对患者的生存和治疗持续时间进行了25年的综合评估.
- 在1996年至2021年期间开始治疗的497名PD患者的回顾性评估.
- 队列分析分为三个时期,反映了关键的技术和治疗进展.
研究的目的:
- 在25年的时间内分析患者存活率和PD治疗持续时间的趋势.
- 为了确定与死亡率和PD到血液透析 (HD) 转移相关的风险因素.
- 了解不断发展的PD技术和解决方案对患者结果的影响.
主要方法:
- 对497名PD患者进行了回顾性队列研究.
- 卡普兰-梅尔生存分析.
- 考克斯的比例危险和灰色子分布危险模型用于生存和转移分析.
主要成果:
- 随着时间的推移,PD作为初始治疗的使用显著增加.
- 五年死亡率为40%. 死亡风险因素包括持续的门诊腹膜透析 (CAPD),年龄较大,心血管疾病和RAASi使用.
- 48%的患者在5年后仍在使用PD. CAPD是PD转移到HD的风险因素,而RAASi使用和女性性别与更长的PD持续时间有关.
结论:
- 在PD解决方案和远程监控方面的进步对PD的结果和采用产生了积极的影响.
- 持续的门诊腹膜透析 (CAPD) 使用与增加的死亡率和转移到血液透析有关.
- 虽然RAASi的使用与更长的PD持续时间有关,但由于研究的观察性质,建议在解释其与死亡率的关联时谨慎行事.
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