Steenkamp Retha, Rao Anirudh, Fraser Simon
UK Renal Registry, Bristol, UK.
Nephron. 2016;132 Suppl 1:111-44. doi: 10.1159/000444819. Epub 2016 Apr 19.
Survival of incident patients on RRT continued to improve over the last 14 years for both short and long term survival up to 10 years post RRT start. One year after 90 day age adjusted survival for incident RRT patients in the 2013 cohort increased to 91.4% from the previous year (91.0%); survival increased in incident patients aged ,65 years and in older patients (565 years). There was a difference in one year after 90 day incident survival by age group and diabetic status: diabetic patients aged ,65 years have slightly worse survival than non-diabetic patients, but survival for older diabetic patients (565 years) was significantly better than for non-diabetic patients. One year age adjusted survival for prevalent dialysis patients was 88.6% in the 2013 cohort, a slight decrease from the 2012 cohort (89.3%). Age adjusted one year survival for prevalent dialysis patients with diabetic primary renal disease has been declining slightly since 2012. Centre and UK country variability was evident in incident and prevalent patient survival after adjusting to age 60 and this finding would benefit from further investigation. The relative one year risk of death on RRT decreased with age from about 19 times that of the general population at age 35–39 years to 2.6 times at age 85 and over. In the prevalent RRT population, cardiovascular disease was the most common cause of death, accounting for 23% of deaths. Infection accounted for 20% of deaths and treatment withdrawal for 16% of deaths.
在过去14年中,接受肾脏替代治疗(RRT)的新发患者的短期和长期生存率(直至RRT开始后10年)持续改善。2013队列中,新发RRT患者90天年龄校正生存率在1年后从之前一年的91.0%升至91.4%;65岁及以下的新发患者和老年患者(≥65岁)的生存率均有所提高。90天新发患者1年后的生存率按年龄组和糖尿病状态存在差异:65岁及以下的糖尿病患者生存率略低于非糖尿病患者,但老年糖尿病患者(≥65岁)的生存率显著高于非糖尿病患者。2013队列中,长期透析患者1年年龄校正生存率为88.6%,较2012队列(89.3%)略有下降。自2012年以来,原发性肾病为糖尿病的长期透析患者的年龄校正1年生存率略有下降。在调整至60岁后,新发和长期患者的生存率在中心和英国各地区存在明显差异,这一发现值得进一步研究。RRT患者1年相对死亡风险随年龄下降,从35 - 39岁时约为普通人群的19倍降至85岁及以上时的2.6倍。在长期RRT人群中,心血管疾病是最常见的死亡原因,占死亡人数的23%。感染占死亡人数的20% , 治疗中断占死亡人数的16%。