泰国血液透析患者的贫血与生存率：来自国家登记数据的证据。

Anemia and survival in Thai hemodialysis patients: evidence from national registry data.

作者信息

Krairittichai Udom, Supaporn Thanom, Aimpun Pote, Wangsiripaisan Adisorn, Chaiprasert Amnart, Sakulsaengprapha Amporn, Chittinandana Anutra, Thanachartwet Wipa, Palasawatdhi Valai, Srangsomwong Soysaang

机构信息

Thailand Renal Replacement Therapy Registry, Nephrology Society of Thailand.

出版信息

J Med Assoc Thai. 2006 Aug;89 Suppl 2:S242-7.

PMID:17044478

Abstract

BACKGROUND

Anemia is a major contributor to morbidity and mortality in chronic dialysis patients. The K/DOQI guideline recommends the target hemoglobin of 11-12 g/dl (hematocrit of 33-36%). However the appropriate hematocrit level for Thai hemodialysis patients has been controversial.

OBJECTIVE

To investigate the influence of anemia on mortality in Thai chronic hemodialysis patients who initiated their dialysis from 1999 through 2003.

MATERIAL AND METHOD

The data from the Thailand Renal Replacement Therapy Registry who has conducted an annual report of chronic dialysis patients throughout Thailand since 1997 was used. Data of twice- and thrice-weekly hemodialysis patients who had recorded hematocrit from 1999 through 2003 were processed and confirmed before final analysis. Records of 3,211 hemodialysis patients from 301 centers were included.

RESULT

The original kidney diseases were diabetes mellitus (31.5%) and hypertension (20.9%). Most patients received twice-weekly hemodialysis (86.3%). The mean hematocrit was 29.3 +/- 5.5%. Most patients (72.8%) had hematocrits of less than 33%. Kaplan-Meier analysis showed patients with hematocrit of ?33% or more had better survival than patients with hematocrits of less than 33% (p <0.01). Patients with hematocrits of less than 27, 27-29.9, 30-32.9 and 36% or more had mortality risks of 1.90 (95% CI: 1.31-2.76, p <0.01), 2.10 (95% CI: 1.42-3.09, p <0.01), 1.74 (95% CI: 1.18-2.56, p <0.01) and 1.174 (95% CI: 0.73-1.90, p = 0.51) respectively, compared to those with hematocrit of 33-35.9%.

CONCLUSION

The best survival can be achieved in Thai patients with hematocrits of at least 33%.

摘要

背景

贫血是慢性透析患者发病和死亡的主要原因。美国肾脏病基金会（K/DOQI）指南建议血红蛋白目标值为11 - 12g/dl（血细胞比容为33% - 36%）。然而，泰国血液透析患者的合适血细胞比容水平一直存在争议。

目的

研究1999年至2003年开始透析的泰国慢性血液透析患者中贫血对死亡率的影响。

材料与方法

使用泰国肾脏替代治疗登记处的数据，该登记处自1997年起对泰国慢性透析患者进行年度报告。对1999年至2003年记录了血细胞比容的每周透析两次和三次的患者数据进行处理并在最终分析前进行确认。纳入了来自301个中心的3211例血液透析患者的记录。

结果

原发性肾脏疾病为糖尿病（31.5%）和高血压（20.9%）。大多数患者每周透析两次（86.3%）。平均血细胞比容为29.3±5.5%。大多数患者（72.8%）的血细胞比容低于33%。Kaplan - Meier分析显示，血细胞比容为33%或更高的患者比血细胞比容低于33%的患者生存率更高（p<0.01）。与血细胞比容为33 - 35.9%的患者相比，血细胞比容低于27%、27 - 29.9%、30 - 32.9%和36%或更高的患者的死亡风险分别为1.90（95%CI：1.31 - 2.76，p<0.01）、2.10（95%CI：1.42 - 3.09，p<0.01）、1.74（95%CI：1.18 - 2.56，p<0.01）和1.174（95%CI：0.73 - 1.90，p = 0.51）。