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不同腹膜透析方式的治疗效果与生存率

Outcome and survival in different peritoneal dialysis modalities.

作者信息

Al-Hilali Nabieh, Al-Humoud Hani, Nampoory Mangalathillam, Ninan Adakethu, Johny Kaivilayil

机构信息

Division of Nephrology, Department of Medicine, Mubarak Al-Kabeer Hospital, Kuwait.

出版信息

Ther Apher Dial. 2007 Apr;11(2):101-6. doi: 10.1111/j.1744-9987.2007.00420.x.

Abstract

Peritoneal dialysis (PD) has been accepted as a treatment option for patients with end-stage renal disease, yet experience with PD in Arab countries is limited. This study was undertaken to evaluate the outcome and survival of different PD modalities. All patients managed at the Mubarak Al-Kabeer Hospital Kuwait between August 1982 and December 2003 using PD for three months or more were included in the study. Demographic features, outcome and survival of the patients were analyzed. Four hundred and fifteen patients with end-stage renal failure were admitted into the PD program. Their mean age was 52.06 +/- 16.43 years. Hospital-based intermittent peritoneal dialysis (IPD), continuous ambulatory peritoneal dialysis (CAPD), nightly intermittent peritoneal dialysis (NIPD) and continuous cycling peritoneal dialysis (CCPD) were preferred by 203 (48.9%), 176 (42.4%), 30 (7.2%) and 6 (1.4%) patients respectively. The mean duration of follow up was 12.7 +/- 11.7 months. Fifty-five (13.3%) patients were continuing on PD, 55 (13.3%) had shifted to hemodialysis, 73 (17.6%) underwent renal transplantation, 114 (27.5%) died, 34 (8.2%) returned to their native countries, 79 (19%) transferred to other centers and follow up was lost for 5 (1.45%) patients. Patient survival at two years was 56%, 72% and 87% in IPD, CAPD and NIPD respectively. Technique survival at two years was 60.6%, 75.4% and 100% in IPD, CAPD and NIPD respectively. Peritoneal dialysis modalities provide a feasible modality of renal replacement therapy. The overall outcome and patient and technique survival in home PD modalities were better than hospital-based PD.

摘要

腹膜透析(PD)已被视为终末期肾病患者的一种治疗选择,但阿拉伯国家在PD方面的经验有限。本研究旨在评估不同PD方式的治疗效果和生存率。1982年8月至2003年12月期间在科威特穆巴拉克·卡比尔医院接受PD治疗三个月及以上的所有患者均纳入本研究。分析了患者的人口统计学特征、治疗效果和生存率。415例终末期肾衰竭患者进入PD项目。他们的平均年龄为52.06±16.43岁。分别有203例(48.9%)、176例(42.4%)、30例(7.2%)和6例(1.4%)患者选择了医院间歇性腹膜透析(IPD)、持续非卧床腹膜透析(CAPD)、夜间间歇性腹膜透析(NIPD)和持续循环腹膜透析(CCPD)。平均随访时间为12.7±11.7个月。55例(13.3%)患者继续接受PD治疗,55例(13.3%)已转为血液透析,73例(17.6%)接受了肾移植,114例(27.5%)死亡,34例(8.2%)返回本国,79例(19%)转至其他中心,5例(1.45%)患者失访。IPD、CAPD和NIPD患者两年生存率分别为56%、72%和87%。IPD、CAPD和NIPD患者两年技术生存率分别为60.6%、75.4%和100%。腹膜透析方式提供了一种可行的肾脏替代治疗方式。家庭PD方式的总体治疗效果以及患者和技术生存率均优于医院PD。

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