Habib Aida, Durand Anne-Claire, Brunet Philippe, Delarozière Jean-Christophe, Devictor Bénédicte, Sambuc Roland, Gentile Stéphanie
Laboratoire de santé publique, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France.
Laboratoire de santé publique, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France.
Nephrol Ther. 2016 Jul;12(4):221-8. doi: 10.1016/j.nephro.2016.01.015. Epub 2016 Jun 16.
To analyze and compare survival of patients initially treated with peritoneal dialysis (PD) or hemodialysis (HD).
We used data from the French REIN registry. We included all patients aged 18 years or more who started dialysis between 1st January 2004 and 12 December 2012 in Provence-Alpes-Côte d'Azur Region (PACA). These patients were followed up until 30 June 2014. Survival curves were generated using the Kaplan-Meier technique and tested using the log-rank test. Variables predictive of all-cause mortality were determined using Cox regression models. The propensity score was used.
Survival was similar between initial dialysis modalities: PD and HD, even after adjusting for the propensity score. But, when we exclude the patients who had switched from one technique of dialysis to another, survival was better in HD patients. According to the multivariate analysis, advanced age and the lack of walking autonomy appear to be associated with an increase in mortality in dialysis patients. But, the presence of hypertension improve the survival in this cohort.
The survival is similar between hemodialysis and peritoneal dialysis.
分析并比较初始接受腹膜透析(PD)或血液透析(HD)治疗的患者的生存率。
我们使用了来自法国REIN注册中心的数据。纳入了2004年1月1日至2012年12月12日期间在普罗旺斯-阿尔卑斯-蓝色海岸大区(PACA)开始透析的所有18岁及以上患者。这些患者随访至2014年6月30日。使用Kaplan-Meier技术生成生存曲线,并使用对数秩检验进行检验。使用Cox回归模型确定全因死亡率的预测变量。采用倾向评分法。
即使在对倾向评分进行调整后,初始透析方式(PD和HD)之间的生存率相似。但是,当我们排除从一种透析技术转换为另一种透析技术的患者后,HD患者的生存率更高。根据多变量分析,高龄和缺乏行走自主性似乎与透析患者死亡率增加有关。但是,高血压的存在可提高该队列患者的生存率。
血液透析和腹膜透析的生存率相似。