肾脏替代治疗期间的发病率和死亡率：透析与移植

Morbidity and mortality during renal replacement therapy: dialysis versus transplantation.

作者信息

Straathof-Galema L, van Saase J L, Verburgh C A, de Fijter J W, Schut N H, van Dorp W T

机构信息

Kennemer Gasthuis, Haarlem, The Netherlands.

出版信息

Clin Nephrol. 2001 Mar;55(3):227-32.

PMID:11316243

Abstract

AIM

Many patients with end-stage renal disease are eligible for renal transplantation. To enable a patient to choose between transplantation or to remain on dialysis comparable data on morbidity and mortality should be available.

METHODS

Data were collected retrospectively from the medical records of all patients on the waiting list for renal transplantation and of transplanted patients during the period January 1, 1990, to January 1, 1997. All patients were dialyzed in the Kennemer Gasthuis and renal transplantation was performed in the Leiden University Medical Center (LUMC). Morbidity and mortality in both groups were compared. Morbidity was assessed by studying number, length and cause of hospital admissions.

RESULTS

During the study period 102 patients had been on the waiting list and 54 patients had been transplanted in the LUMC. Mean length of stay on the waiting list before transplantation was 37 months. During the follow-up period 11 patients (10.8%) died on the waiting list and 6 patients (11.1%) died after renal transplantation. The mean length of stay on the waiting list of these two groups was much longer, being 55 months and 62 months, respectively. Length of hospitalization was significantly different between both patient groups during the first 6 months of treatment (13.24 days for those on the waiting list versus 40.75 days transplanted patients) and after 6 months (32.4 days for those on the waiting list versus 13.1 days transplanted patients). The number of hospital admissions did not differ significantly. Dialysis-related admissions constituted 47% of the total of admissions in the waiting list group and transplantation-related admissions were 43% in the transplanted group.

CONCLUSION

In the present study we revealed no difference in overall mortality. However, mortality was influenced by length of stay on the waiting list. Morbidity was increased during the first 6 months after transplantation. Therapy modality greatly influenced the specific cause of morbidity.

摘要

目的

许多终末期肾病患者适合接受肾移植。为使患者能够在移植和继续接受透析之间做出选择，应提供关于发病率和死亡率的可比数据。

方法

回顾性收集1990年1月1日至1997年1月1日期间所有肾移植等待名单上患者及已移植患者的病历数据。所有患者均在肯内默加斯豪伊斯接受透析，肾移植在莱顿大学医学中心（LUMC）进行。比较两组的发病率和死亡率。通过研究住院次数、住院时间和住院原因来评估发病率。

结果

在研究期间，102名患者在等待名单上，54名患者在LUMC接受了移植。移植前在等待名单上的平均停留时间为37个月。在随访期间，11名患者（10.8%）在等待名单上死亡，6名患者（11.1%）在肾移植后死亡。这两组在等待名单上的平均停留时间长得多，分别为55个月和62个月。在治疗的前6个月，两组患者的住院时间有显著差异（等待名单上的患者为13.24天，移植患者为40.75天），6个月后也有差异（等待名单上的患者为32.4天，移植患者为13.1天）。住院次数没有显著差异。与透析相关的住院占等待名单组总住院次数的47%，与移植相关的住院在移植组中占43%。