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血液透析和腹膜透析患者并发急性脑出血的对比结局。

Comparative outcomes between hemo- and peritoneal dialysis patients with acute intracerebral hemorrhage.

机构信息

Stroke Center, National Cheng Kung University Hospital, Tainan, Taiwan.

出版信息

Am J Nephrol. 2010;32(1):31-7. doi: 10.1159/000312228. Epub 2010 May 19.

Abstract

BACKGROUND/AIMS: The optimal mode of dialysis for end-stage renal disease (ESRD) patients with spontaneous intracerebral hemorrhage (ICH) remains controversial. We compared the outcomes of ESRD patients who received continuous peritoneal dialysis (CPD) or extended hemodialysis (EHD) after ICH, and investigated the factors determining prognosis.

METHODS

We incorporated our ICH patients with ESRD, requiring dialysis from January 2005 to December 2009. Patients were allocated to the CPD or EHD group according to the dialysis mode after ICH. We compared the 30-day mortality rate and modified Rankin Scale (mRS) of the two groups and analyzed the factors associated with mortality.

RESULTS

There were 40 patients with 16 episodes in CPD and 27 episodes in EHD group, without significant differences in baseline demographic data. The 30-day mortality rate and mRS were not different between the two groups. The patients who died within 30 days had higher ICH scores (4 +/- 1 vs. 1 +/- 1, p < 0.001) and outcome scores (5 +/- 2 vs. 1 +/- 1, p < 0.001). Dialysis-related complications occurred more frequently in the PD group (p = 0.07), but were unrelated to mortality.

CONCLUSION

Among ESRD patients with ICH, EHD had a similar 30-day mortality rate and 30-day mRS to those receiving CPD. The mortality was significantly related to the severity of ICH.

摘要

背景/目的:终末期肾病(ESRD)并发自发性脑出血(ICH)患者的最佳透析模式仍存在争议。我们比较了 ESRD 患者脑出血后接受持续腹膜透析(CPD)或扩展血液透析(EHD)的结局,并探讨了决定预后的因素。

方法

我们纳入了 2005 年 1 月至 2009 年 12 月期间需要透析的 ICH 合并 ESRD 患者。根据脑出血后透析模式将患者分为 CPD 或 EHD 组。比较两组患者的 30 天死亡率和改良 Rankin 量表(mRS)评分,并分析与死亡率相关的因素。

结果

CPD 组有 16 例,EHD 组有 27 例,两组患者的基线人口统计学数据无显著差异。两组患者的 30 天死亡率和 mRS 评分无差异。30 天内死亡的患者 ICH 评分(4 +/- 1 比 1 +/- 1,p < 0.001)和结局评分(5 +/- 2 比 1 +/- 1,p < 0.001)更高。PD 组透析相关并发症更常见(p = 0.07),但与死亡率无关。

结论

在 ESRD 并发 ICH 的患者中,EHD 的 30 天死亡率和 30 天 mRS 与 CPD 相似。死亡率与 ICH 的严重程度显著相关。

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