Neu Alicia M, Ho P L Martin, McDonald Ruth A, Warady Bradley A
The Jhons Hopkins University School of Medicine, Baltimere, Maryland, USA.
Pediatr Nephrol. 2002 Aug;17(8):656-63. doi: 10.1007/s00467-002-0928-9. Epub 2002 Jun 21.
The 2001 annual report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) registry includes data on 4,546 dialysis patients. Important trends in dialysis care include a significant increase in the use of peritoneal dialysis catheters with two cuffs (51.6% vs. 36.2%, P<0.001), a Swan neck tunnel (34.1% vs. 20.9%, P<0.001), and a downward pointing exit site (34.9% vs. 29.5%, P<0.001) in patients who initiated dialysis between 1997 and 2000 compared with 1992-1996. Most hemodialysis patients continued to have an external percutaneous catheter as their access at the time of initiation of dialysis (1,550/1,971 patients, 78.6%), but the odds of using a jugular rather than a subclavian vein for these catheters increased by 24% each year between 1992 and 2000. There was a significant trend for increasing use of erythropoietin and by 1996, 96% of patients were prescribed this medication at initiation of dialysis. There was also a modest, but significant, increase in hematocrit in the dialysis registry, as the median hematocrit at 6 months of follow-up was 31% in patients who started dialysis between 1997 and 2000 ( P<0.001).
北美儿科肾移植协作研究（NAPRTCS）登记处2001年的年度报告包含了4546名透析患者的数据。透析护理的重要趋势包括：与1992 - 1996年相比，1997年至2000年开始透析的患者中，使用双袖口腹膜透析导管的比例显著增加（51.6%对36.2%，P<0.001），使用鹅颈隧道导管的比例显著增加（34.1%对20.9%，P<0.001），以及使用向下指向出口部位的导管的比例显著增加（34.9%对29.5%，P<0.001）。大多数血液透析患者在开始透析时仍以外部经皮导管作为血管通路（1550/1971名患者，78.6%），但在1992年至2000年期间，这些导管使用颈静脉而非锁骨下静脉的几率每年增加24%。促红细胞生成素的使用有显著增加的趋势，到1996年，96%的患者在开始透析时就被开了这种药。透析登记处的血细胞比容也有适度但显著的增加，因为在1997年至2000年开始透析的患者中，随访6个月时血细胞比容的中位数为31%（P<0.001）。
