75岁及以上末期脏病患者选择透析方式:多中心队列研究
Yaohua Hu1, Xueyan Zhu2, Yingying Liu3
1Department of Nephrology, The Second Hospital of Jilin University, No. 4026 Yatai Street, Changchun, 130041, Jilin Province, China.
Scientific reports
|December 14, 2025
概括
对于患有末期脏病 (ESKD) 的非常老年患者,这项研究发现血液透析 (HD) 和腹腔透析 (PD) 之间的生存率没有显著差异. 这两种透析方法在这个脆弱人群中提供了可比的结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 末期病 (ESKD) 影响老年人不成比例,在治疗选择方面提出了挑战.
- 对于非常老年ESKD患者来说,最优的透析方式 (血液透析与腹腔透析) 缺乏可靠的证据.
- 在这个人群中,血液透析 (HD) 与腹腔透析 (PD) 的生存益处尚不清楚.
研究的目的:
- 为了比较血液透析 (HD) 和腹腔透析 (PD) 的生存结果,在患有末期脏疾病 (ESKD) 的非常老年患者中.
- 为在患有ESKD的老年人群中选择透析方式提供基于证据的见解.
主要方法:
- 一项多中心队列研究,涉及234名来自中国六家医院的ESKD的非常老年患者 (≥75岁).
- 倾向分数匹配 (PSM) 用于控制HD和PD组之间的混变量.
- 使用卡普兰-梅尔曲线,日志等级测试和多变量考克斯比例危险回归分析了生存率.
主要成果:
- 在PSM之后,在每个组中 (HD与PD) 匹配了56名患者,平均年龄为79.76岁.
- 卡普兰-梅尔分析显示,HD和PD之间的生存率没有统计学上显著的差异 (逻辑等级p=0.123).
- 考克斯回归分析也显示生存率没有显著差异 (HR=0.73;95% CI:0.49,1.10;p=0.132).
结论:
- 这项研究发现,在末期脏疾病的非常老年患者中,血液透析和腹腔透析之间的生存率没有统计学上显著的差异.
- 在这个人群中,透析方式的选择可能不会显著影响整体存活率.
- 进一步的研究可以探索生命质量和其他以患者为中心的结果,而不仅仅是生存.
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