腹腔透析的渐进性开始和临床结果:PDOPPS的国际结果
Ashik Hayat1,2,3, Melissa S Cheetham4,5,6, Yeoungjee Cho1,2,3
1Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia.
概括
在大约三分之一的患者中,开始增量腹腔透析 (PD). 这种方法显示,与标准PD相比,血液透析转移,腹膜炎和死亡的风险相当.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 脏替代疗法治疗 脏替代疗法
- 透析的实践 透析的实践
背景情况:
- 对增量腹膜透析 (PD) 对患者结果的影响的理解有限.
- 缺乏基于证据的指导方针来启动PD透析剂量.
- 需要比较PD开始时的PD处方实践及其临床结果的关联.
研究的目的:
- 为了比较在透析开始时的PD处方实践.
- 评估PD处方和临床结果之间的关联.
- 评估增量PD与标准PD对结果的影响.
主要方法:
- 国际前性队列研究 (PDOPPS).
- 包括在注册前3个月开始PD的成年患者 (2014年1月至2017年12月).
- 定义的增量PD (<4次/天CAPD或<7天/周APD) 与标准PD;使用回归模型分析了转移到血液透析 (HD),腹膜炎和死亡率.
主要成果:
- 包括1365名患者;37%开始增量PD,63%开始标准PD.
- 与日本相关的PD增量吸收,年龄超过75岁,使用icodextrin,较低的肌素,更高的设施PD患者数量.
- 在增量和标准PD组之间,HD传输率 (IRR 0.93,p=0.49),腹膜炎或死亡率没有显著差异.
结论:
- 在大约三分之一的患者处方增量PD开始.
- 低确定性证据表明,HD转移,腹膜炎和因增量PD死亡的风险相似.
- 需要进一步的研究来巩固PD启动剂量的最佳实践.
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