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紧急启动腹膜透析:巴西首年经验。

Urgent-Start Peritoneal Dialysis: The First Year of Brazilian Experience.

机构信息

São Paulo State University - UNESP, Alameda dasHortencias, Botucatu, Brazil.

出版信息

Blood Purif. 2017;44(4):283-287. doi: 10.1159/000478970. Epub 2017 Oct 25.

Abstract

BACKGROUND

This study aimed to evaluate mechanical and infectious complications associated with urgent-start peritoneal dialysis (PD) and patients and technique survival in the first 180 days.

METHODS

It was a prospective study that evaluated chronic patients who started unplanned PD using high-volume PD (HVPD) right after (<72 h) PD catheter placement. After hospital discharge, patients were treated with intermittent PD on alternate days in a dialysis unit until family training was provided.

RESULTS

Fifty-one patients fulfilling the following criteria were included: age was 62.1 ± 15 years, with diabetes as the main etiology of end-stage renal disease (39%), and uremia as the main dialysis indication (76%). Metabolic and fluid controls were achieved after 3 sessions of HVPD, and patients remained in intermittent PD for 23.2 ± 7.2 days. Mechanical complications occurred in 25.7% and peritonitis rate was 0.5 episode/patient-year. In the first 6 months, technique and patients survival rates were 86 and 82.4% respectively.

CONCLUSION

The PD modality was a feasible and safe alternative to hemodialysis in the urgent-start dialysis.

摘要

背景

本研究旨在评估紧急启动腹膜透析(PD)相关的机械和感染并发症,以及患者和技术在最初 180 天的存活率。

方法

这是一项前瞻性研究,评估了在 PD 导管放置后立即(<72 小时)使用高容量 PD(HVPD)开始计划外 PD 的慢性患者。出院后,患者在透析中心接受间歇性 PD 治疗,每两天交替进行,直到提供家庭培训。

结果

51 名符合以下标准的患者被纳入研究:年龄 62.1 ± 15 岁,糖尿病是终末期肾病(ESRD)的主要病因(39%),尿毒症是主要透析指征(76%)。经过 3 次 HVPD 治疗后,代谢和液体控制得到了改善,患者继续接受间歇性 PD 治疗 23.2 ± 7.2 天。机械并发症发生率为 25.7%,腹膜炎发生率为 0.5 例/患者年。在最初的 6 个月里,技术和患者的存活率分别为 86%和 82.4%。

结论

PD 是一种可行且安全的紧急透析替代血液透析的方法。

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