欧洲过去十年家庭透析的发展趋势:ERA注册研究
Maria Fernanda Slon-Roblero1, Vianda S Stel2,3, Emilio Sanchez-Alvarez4
1Department of Nephrology, Hospital Universitario de Navarra, Pamplona, Spain.
概括
在2012年至2021年期间,家庭血液透析 (HHD) 的使用量增加,而腹腔透析 (PD) 的使用量下降. 家庭透析的总体患病率仍然很低,这表明需要改进的策略来增加患者获得这些置换疗法.
科学领域:
- 科和泌尿科
- 公共卫生
- 医疗服务研究
背景情况:
- 家庭透析治疗,包括家庭血液透析 (HHD) 和腹腔透析 (PD),为需要透析的患者提供潜在的优势.
- 了解家庭透析和治疗之间的转换趋势对于优化置换疗法 (KRT) 策略至关重要.
研究的目的:
- 研究2012年至2021年欧洲国家HHD和PD发病率和流行率的趋势.
- 评估患者在家庭透析方式与其他KRT之间进行的转换,包括中心HD和移植.
主要方法:
- 从欧洲脏协会 (ERA) 登记处获得的来自13个欧洲国家的成年KRT患者数据的分析.
- 评估家庭透析启动率,每年流行率以及启动HHD或PD之前和之后的过渡.
主要成果:
- 在2012年至2021年期间,HD发病率和患病率增加,而PD发病率和患病率下降,导致整体家庭透析率稳定.
- 家庭透析占KRT总患病率的5. 8%;大多数HHD患者从中心的HD过渡,而大多数PD患者之前没有KRT.
- 开始治疗后两年,HHD患者的结局包括53. 2%的患者继续接受HHD治疗,20. 9%的患者接受移植,16. 6%的患者转移到中心治疗的HD治疗. 其中39.6%的患者仍在接受PD治疗,22. 6%的患者转换为中心性HD治疗,18. 3%的患者接受了移植.
结论:
- 尽管一些欧洲国家的HHD使用量有所增加,但PD使用量有所下降,两种模式的总体流行率仍然很低.
- 从其他KRT过渡到家庭透析和家庭透析模式之间是有限的.
- 显然需要制定和实施特定区域的战略,以提高患者获得有益的家庭透析治疗的机会.
相关概念视频
01:25Hemodialysis I: Introduction
282
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
282
01:27Dialysis
473
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...
473
01:24Hemodialysis II: Procedure and Complications
128
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
128
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
105
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
105
01:25Hemodialysis III: Nursing Management
181
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
181
01:30Peritoneal Dialysis I: Introduction and Procedure
197
Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
197