Qazi Hammad Ali, Chen Helen, Zhu Meng
School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada.
BMC Nephrol. 2018 Apr 24;19(1):96. doi: 10.1186/s12882-018-0894-5.
Research on factors associated with dialysis withdrawal is scarce. This study examined the predictors that might influence rate of dialysis withdrawal. Existing literature is summarized, analyzed and synthesized to identify gaps in the literature with regard to the factors associated with dialysis withdrawal.
This scoping review used a systematic search to synthesize research findings related to dialysis withdrawal and identified gaps in the literature. The search strategy was developed and applied using PubMed, EMBASE and CINHAL databases. The selection criteria included articles written in English and published between 1997 and 2016 that examined dialysis withdrawal and associated factors in patients with any modality of renal dialysis.. Case reports and studies only including renal transplant patients were excluded. Fifteen articles were selected in accordance with these selection criteria.
The literature review revealed a scarcity of research on dialysis withdrawal and associated factors. Furthermore, the study findings were inconsistent and inconclusive. Authors have defined dialysis withdrawal in terms of dialysis discontinuation, withholding, death, withdrawal, treatment refusal/cessation, or technique failure. Authors have selected homogeneous patient population on either hemodialysis (HD) or peritoneal dialysis (PD) patients, thus making comparisons of studies and generalization of findings difficult.
Future studies should explore the influence of both HD and PD on patient-elected dialysis withdrawal using a large a priori calculated sample size.
关于与透析撤机相关因素的研究较少。本研究探讨了可能影响透析撤机率的预测因素。对现有文献进行总结、分析和综合，以找出与透析撤机相关因素方面的文献空白。
本范围综述采用系统检索来综合与透析撤机相关的研究结果，并找出文献中的空白。检索策略通过使用PubMed、EMBASE和CINHAL数据库制定并应用。选择标准包括1997年至2016年间发表的英文文章，这些文章研究了任何肾脏透析方式患者的透析撤机及相关因素。排除病例报告和仅纳入肾移植患者的研究。根据这些选择标准筛选出15篇文章。
文献综述显示，关于透析撤机及相关因素的研究较少。此外，研究结果不一致且无定论。作者们对透析撤机的定义包括透析中断、 withholding、死亡、撤机、治疗拒绝/停止或技术失败。作者们选择的患者群体要么是血液透析（HD）患者，要么是腹膜透析（PD）患者，具有同质性，因此难以对研究进行比较并归纳研究结果。
未来的研究应使用事先计算好的大样本量，探讨血液透析和腹膜透析对患者自主选择的透析撤机的影响。
