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腹膜透析和血液透析患者新发糖尿病:发生率、危险因素及预后——综述

New-Onset Diabetes Mellitus in Peritoneal Dialysis and Hemodialysis Patients: Frequency, Risk Factors, and Prognosis-A Review.

作者信息

Yarragudi Rajashri, Gessl Alois, Vychytil Andreas

机构信息

Clinical Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria.

Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.

出版信息

Ther Apher Dial. 2019 Dec;23(6):497-506. doi: 10.1111/1744-9987.12800. Epub 2019 Apr 23.

Abstract

New-onset diabetes mellitus (NODM) is observed in both hemodialysis (HD) and peritoneal dialysis (PD) patients. The prevalence of NODM in dialysis patients is slightly higher compared to subjects of the general population. Based on currently published data there is no convincing evidence that the risk of NODM is different between HD and PD patients. Data on the effect of glucose load on risk of NODM in dialysis patients remain controversial. PD modality (automated or continuous ambulatory PD) has no significant influence on NODM incidence. Chronic inflammation is associated with NODM in dialysis patients. Reported differences in NODM between PD and HD patients are possibly also influenced by differences in demographic factors between these patient groups. Mortality in NODM patients is lower than mortality in patients with preexisting DM. This may be partly explained by the younger age and lower number of comorbidities in patients with NODM.

摘要

血液透析(HD)和腹膜透析(PD)患者中均观察到新发糖尿病(NODM)。与普通人群相比,透析患者中NODM的患病率略高。根据目前已发表的数据,没有令人信服的证据表明HD和PD患者发生NODM的风险存在差异。关于葡萄糖负荷对透析患者发生NODM风险影响的数据仍存在争议。PD模式(自动化或持续非卧床腹膜透析)对NODM发病率没有显著影响。慢性炎症与透析患者的NODM相关。PD和HD患者之间NODM的报道差异可能也受到这些患者群体人口统计学因素差异的影响。NODM患者的死亡率低于既往患有糖尿病(DM)的患者。这可能部分归因于NODM患者年龄较轻且合并症较少。

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