透析方式对 HCV 感染的 ESRF 患者生存的影响。
Effect of dialysis modality on survival of hepatitis C-infected ESRF patients.
机构信息
Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia.
出版信息
Clin J Am Soc Nephrol. 2011 Nov;6(11):2657-61. doi: 10.2215/CJN.02200311. Epub 2011 Sep 8.
BACKGROUND AND OBJECTIVES
Hepatitis C virus (HCV) infection is associated with increased mortality and morbidity in end-stage renal failure (ESRF) patients. Despite a lower incidence and risk of transmission of HCV infection with peritoneal dialysis (PD), the optimal dialysis modality for HCV-infected ESRF patients is not known. The aim of this study was to evaluate the impact of dialysis modality on the survival of HCV-infected ESRF patients.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The study included all adult incident ESRF patients in Australia and New Zealand who commenced dialysis between January 1, 1994, and December 31, 2008, and were HCV antibody-positive at the time of dialysis commencement. Time to all-cause mortality was compared between hemodialysis (HD) and PD according to modality assignment at day 90, using Cox proportional hazards model analysis.
RESULTS
A total of 424 HCV-infected ESRF patients commenced dialysis during the study period and survived for at least 90 days (PD n = 134; HD n = 290). Mortality rates were comparable between PD and HD in the first year (10.7 versus 13.8 deaths per 100 patient-years, respectively; adjusted hazard ratio [HR] 0.65, 95% CI 0.34 to 1.26) and thereafter (20 versus 15.9 deaths per 100 patient-years, respectively; HR 1.27, 95% CI 0.86 to 1.88).
CONCLUSIONS
The survival of HCV-infected ESRF patients is comparable between PD and HD.
背景和目的
丙型肝炎病毒（HCV）感染与终末期肾衰竭（ESRF）患者的死亡率和发病率增加有关。尽管腹膜透析（PD）的 HCV 感染发生率和传播风险较低，但 HCV 感染的 ESRF 患者的最佳透析方式尚不清楚。本研究旨在评估透析方式对 HCV 感染的 ESRF 患者生存的影响。
设计、地点、参与者和测量：该研究包括 1994 年 1 月 1 日至 2008 年 12 月 31 日期间在澳大利亚和新西兰开始透析的所有成年 ESRF 患者，并且在开始透析时 HCV 抗体呈阳性。使用 Cox 比例风险模型分析，根据第 90 天的模式分配，比较血液透析（HD）和 PD 之间的全因死亡率。
结果
在研究期间，共有 424 名 HCV 感染的 ESRF 患者开始透析，并且至少存活了 90 天（PD n = 134；HD n = 290）。在第一年，PD 和 HD 的死亡率相当（分别为每 100 患者年 10.7 和 13.8 例死亡；调整后的危险比[HR] 0.65，95%CI 0.34 至 1.26），此后（分别为每 100 患者年 20 和 15.9 例死亡；HR 1.27，95%CI 0.86 至 1.88）。
结论
HCV 感染的 ESRF 患者的生存在 PD 和 HD 之间相当。
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