Matos Jorge Paulo Strogoff de, Almeida Jorge Reis, Guinsburg Adrian, Marelli Cristina, Barra Ana Beatriz Lesqueves, Vasconcellos Marcos Sandro, José D'Almeida Filho Eufrônio, Hoette Marcos, Ruzany Frederico, Lugon Jocemir Ronaldo
Division of Nephrology, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil.
J Bras Nefrol. 2011 Dec;33(4):436-41.
Brazil has the third largest contingent of patients on maintenance hemodialysis (HD) worldwide. However, little is known regarding survival rate and predictors of mortality risk in that population, which are the purposes of this study. A total of 3,082 patients incident on HD, from 2000 to 2004, at 25 dialysis facilities distributed among 7 out of 26 states of Brazil were followed-up until 2009. Patients were 52 ± 16 years-old, 57.8% men, and 20.4%, diabetics. The primary outcome was all causes of mortality. Data were censored at five years of follow-up. The global five-year survival rate was 58.2%. In the Cox proportional model, variables associated with risk of death were: age (hazard ratio - HR = 1.44 per decade, p < 0.0001), diabetes (HR = 1.51, p < 0.0001), serum albumin (HR = 0.76 per g/dL, p = 0.001), creatinine (HR = 0.92 per mg/dL, p < 0.0001), and phosphorus (HR = 1.06 per mg/dL, p = 0.04). The present results show that the mortality rate on HD in this Brazilian cohort was relatively low, but the population is younger and with a lower prevalence of diabetes than the ones reported for developed countries.
巴西是全球接受维持性血液透析（HD）患者数量第三多的国家。然而，关于该人群的生存率及死亡风险预测因素却知之甚少，而这正是本研究的目的所在。对2000年至2004年间在巴西26个州中7个州的25家透析机构开始接受HD治疗的3082例患者进行随访，直至2009年。患者年龄为52±16岁，男性占57.8%，糖尿病患者占20.4%。主要结局为各种原因导致的死亡。随访数据在5年时进行截尾。全球5年生存率为58.2%。在Cox比例模型中，与死亡风险相关的变量有：年龄（风险比 - HR = 每增加十岁为1.44，p < 0.0001）、糖尿病（HR = 1.51，p < 0.0001）、血清白蛋白（HR = 每克/分升为0.76，p = 0.001）、肌酐（HR = 每毫克/分升为0.92，p < 0.0001）以及磷（HR = 每毫克/分升为1.06，p = 0.04）。目前的结果表明，该巴西队列中HD患者的死亡率相对较低，但与发达国家报道的人群相比，该人群更年轻且糖尿病患病率更低。
