al-Muhanna F A, Saeed I, al-Muelo S, Larbi E, Rubaish A
College of Medicine and Medical Sciences, King Faisal University, Al-Khobar, Saudi Arabia.
East Afr Med J. 1999 Dec;76(12):664-7.
To determine the primary renal disease, acute complications and long term outcome of patients with end stage renal disease(ESRD) undergoing maintenance haemodialysis (MHD).
A prospective descriptive study.
King Faisal Hospital of the University, Al-Khobar, Saudi Arabia.
Patients who had chronic renal failure with end stage renal disease (ESRD) and had been on regular dialysis for more than three months between September 1983 and September 1996 were included in the study. They were classified into three age groups, namely, group I comprising those aged below 29 years (48 patients); group II 30-59 years (147 patients), and group III, those aged 60 years and above (38 patients). Data were collected on disease characteristics, laboratory and radiological investigations, intra-dialytic complications and long-term outcome. The nature of renal disease was ascertained by review of medical data, clinical examination and laboratory investigations.
Two hundred and thirty-three patients with ESRD on MHD were studied. The major causes of ESRD were chronic glomerulonephritis (42.9%) and diabetic nephropathy (27.9%). Hypotension, the most frequent acute complication was seen in 27% of dialytic treatments. Long-term complications resulted mainly from the vascular access and included thrombosis (60 cases), infection (50 cases), haemorrhage from access sites (20 cases) and aneurysmal dilatation (13 cases). These were more frequent in diabetics. Survival in groups I, II and III were 95%, 84% and 27% respectively at the end of the study. The 53 (22.7%) deaths that occurred in the whole study population were mostly due to cerebrovascular accidents (24.5%), cardiovascular events (15.1%), pulmonary oedema and sepsis, each contributed 13.2% of the deaths.
In our patients with chronic renal failure on MHD, younger patients had better survival than the elderly. The main causes of death were cardiovascular and cerebrovascular diseases. Hypotension was the most frequent acute complication. Long-term complications were frequent, especially in diabetics.
确定接受维持性血液透析（MHD）的终末期肾病（ESRD）患者的原发性肾脏疾病、急性并发症及长期预后。
一项前瞻性描述性研究。
沙特阿拉伯胡拜尔法赫德国王大学医院。
1983年9月至1996年9月期间患有慢性肾衰竭并处于终末期肾病（ESRD）且已规律透析超过3个月的患者纳入本研究。他们被分为三个年龄组，即，I组为年龄低于29岁的患者（48例）；II组为30 - 59岁的患者（147例），III组为60岁及以上的患者（38例）。收集了疾病特征、实验室及影像学检查、透析期间并发症和长期预后的数据。通过查阅医疗资料、临床检查及实验室检查确定肾脏疾病的性质。
对233例接受MHD的ESRD患者进行了研究。ESRD的主要病因是慢性肾小球肾炎（42.9%）和糖尿病肾病（27.9%）。低血压是最常见的急性并发症，在27%的透析治疗中出现。长期并发症主要源于血管通路，包括血栓形成（60例）、感染（50例）、通路部位出血（20例）和动脉瘤样扩张（13例）。这些在糖尿病患者中更为常见。研究结束时，I组、II组和III组的生存率分别为95%、84%和27%。整个研究人群中发生的53例（22.7%）死亡主要归因于脑血管意外（24.5%）、心血管事件（15.1%）、肺水肿和败血症，各占死亡人数的13.2%。
在我们接受MHD的慢性肾衰竭患者中，年轻患者的生存率高于老年患者。主要死亡原因是心血管和脑血管疾病。低血压是最常见的急性并发症。长期并发症很常见，尤其是在糖尿病患者中。
