根据PD第一政策泰国在不同透析模式下患者存活率和移植
Pornpen Sangthawan1, Thammasin Ingviya2, Songyos Rajborirug3
1Division of Nephrology, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
PloS one
|November 19, 2025
概括
从腹膜透析 (PD) 转换为血液透析 (HD) 改善了泰国患者的生存率. 在透析组中,移植 (KT) 的结果在透析组中相似,突出了个性化护理需求.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 公共卫生政策 公共卫生政策
- 流行病学 流行病学
背景情况:
- 泰国的全民医疗保险 (UHC) 从2008年至2022年开始实施腹腔透析 (PD-first) 政策.
- 这一政策旨在通过模式选择和过渡来优化置换疗法 (KRT).
研究的目的:
- 评估患者在透析和移植后 (KT) 的存活率.
- 确定影响UHC患者在PD,血液透析 (HD) 或在模式之间过渡的生存的因素.
主要方法:
- 对患有PD,HD,PD到HD以及HD到PD过渡的患者的NHSO数据 (2013-2021) 的回顾性分析.
- 考克斯的比例危险模型被用来确定生存因素.
主要成果:
- 与其他组相比,从PD过渡到HD的患者表现出较高的3年和5年生存率.
- 年龄,糖尿病和并发症显著影响透析存活率;年龄,心脏病,抗体中介排斥和延迟的移植功能影响了KT后的存活率.
- 较高的百分比的PD患者接受了KT (70.4%),而不是HD患者 (19.8%).
结论:
- 从PD过渡到HD与更好的生存结果有关,而不是维持单一透析模式或从HD切换到PD.
- 移植 (KT) 存活率是可比的,无论之前的透析方式如何.
- 个性化透析方式选择和过渡规划对于优化KRT患者结果至关重要.
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