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伊朗腹膜透析十七年经验:伊朗腹膜透析登记处的首份官方报告

Seventeen years' experience of peritoneal dialysis in Iran: first official report of the Iranian peritoneal dialysis registry.

作者信息

Najafi Iraj, Alatab Sudabeh, Atabak Shahnaz, Majelan Nader Nouri, Sanadgol Houshang, Makhdoomi Khadijeh, Ardalan Mohammad Reza, Azmandian Jalal, Shojaee Abbas, Keshvari Amir, Hosseini Mostafa

机构信息

Division of Nephrology, Shariati Hospital, and Nephrology Research Center, Tehran University of Medical Sciences, Tehran; Division of Nephrology, Modares Hospital, Shahid Beheshti University of Medical Sciences, Tehran; Division of Nephrology, Sadoughi Hospital, Yazd University of Medical Sciences, Yazd; Division of Nephrology, Ali-ebn Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan; Division of Nephrology, Imam Khomeini Hospital, Urmiah University of Medical Sciences, Urmiah; Division of Nephrology, Imam Hospital, Tabriz University of Medical Sciences, Tabriz; Division of Nephrology, Shafa Hospital, Kerman University of Medical Sciences, Kerman; Pegahsoft, Khorasan Science and Technology Park, Mashad; Division of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran; and Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Perit Dial Int. 2014 Sep-Oct;34(6):636-42. doi: 10.3747/pdi.2012.00054. Epub 2013 Jun 3.

Abstract

BACKGROUND

To facilitate planning, national renal registries provide reliable and up-to-date information on numbers of patients with end-stage renal disease (ESRD), developing trends, treatment modalities, and outcomes. To that end, the present publication represents the first official report from Iranian Peritoneal Dialysis Registry.

METHODS

The prevalence, demographics, and clinical characteristics of patients on peritoneal dialysis (PD) were collected from all PD centers throughout the country.

RESULTS

By the end of 2009, the prevalence of ESRD was 507 per million population in Iran. The most common renal replacement modality was hemodialysis (51.2%), followed by kidney transplantation (44.7%), and then PD (4.1%). The mean age of PD patients was 46 years, and the most common causes of ESRD were diabetes (33.5%), hypertension (24.4%), and glomerulonephritis (8.2%). Overall patient mortality was 25%, with cardiac events (46%), cerebral stroke (10%), and infection (8%) being the main causes of death. The 1-, 3-, and 5-year survivals were 89%, 64%, and 49% respectively. The most common cause of dropout was peritonitis (17.6%). Staphylococcus (coagulase-negative and S. aureus) was the most prevalent causative organism in peritonitis episodes; however, in more than 50% of episodes, a sterile culture was reported. Mean baseline serum hemoglobin and albumin were 10.7 g/dL and 3.6 g/dL respectively.

CONCLUSIONS

Our registry results, representing the second largest report of PD in the Middle East, is almost comparable to available regional data. We hope that, in future, we can improve our shortcomings and lessen the gap with developed countries.

摘要

背景

为便于规划,国家肾脏登记处提供有关终末期肾病(ESRD)患者数量、发展趋势、治疗方式及预后的可靠且最新信息。为此,本出版物是伊朗腹膜透析登记处的首份官方报告。

方法

从全国所有腹膜透析(PD)中心收集接受腹膜透析患者的患病率、人口统计学及临床特征。

结果

截至2009年底,伊朗ESRD的患病率为每百万人口507例。最常见的肾脏替代方式是血液透析(51.2%),其次是肾移植(44.7%),然后是腹膜透析(4.1%)。腹膜透析患者的平均年龄为46岁,ESRD最常见的病因是糖尿病(33.5%)、高血压(24.4%)和肾小球肾炎(8.2%)。患者总体死亡率为25%,心脏事件(46%)、脑卒中(10%)和感染(8%)是主要死亡原因。1年、3年和5年生存率分别为89%、64%和49%。退出治疗最常见的原因是腹膜炎(17.6%)。葡萄球菌(凝固酶阴性葡萄球菌和金黄色葡萄球菌)是腹膜炎发作中最常见的致病微生物;然而,在超过50%的发作中,报告为无菌培养。平均基线血清血红蛋白和白蛋白分别为10.7 g/dL和3.6 g/dL。

结论

我们的登记结果是中东地区关于腹膜透析的第二大报告,几乎与现有区域数据相当。我们希望未来能够改进不足之处,缩小与发达国家的差距。

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