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腹膜透析患者死亡的风险因素:系统评价和荟萃分析。

Risk factors for mortality in patients undergoing peritoneal dialysis: a systematic review and meta-analysis.

机构信息

Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

出版信息

Ren Fail. 2021 Dec;43(1):743-753. doi: 10.1080/0886022X.2021.1918558.

Abstract

Inconsistent investigations of the risk factors for all-cause mortality in patients undergoing peritoneal dialysis (PD) were reported. The present meta-analysis aimed to assess the impact of some clinical characteristics on the risk of mortality in PD patients. PubMed and Embase were systematically searched for studies evaluating the risk factors for all-cause mortality in PD patients. Hazard ratio (HR) and 95% confidence interval (CI) were derived using a random-effect or fixed-effect model considering the heterogeneity across studies. A total of 26 studies were included in this meta-analysis in accordance with the inclusion and exclusion criteria. Age, primary cardiovascular diseases, diabetes mellitus, and high level of alkaline phosphatase showed significant positive associations with elevated risk of all-cause and cardiovascular mortality in PD patients, while hemoglobin acted as a benefit factor. Furthermore, early onset of peritonitis, high peritoneal transport status, elevated body mass index and high-sensitivity C-reactive protein could also considerably increase the risk of all-cause mortality. The absolute serum level of magnesium, potassium, and uric acid required to improve survival in PD patients should be verified further. Multiple factors could affect the risk of mortality in PD patients.

摘要

在接受腹膜透析 (PD) 的患者中,有关全因死亡率风险因素的研究结果并不一致。本荟萃分析旨在评估某些临床特征对 PD 患者死亡风险的影响。通过系统地检索 PubMed 和 Embase,评估了 PD 患者全因死亡率风险因素的研究。使用随机效应或固定效应模型,根据研究之间的异质性,得出风险比 (HR) 和 95%置信区间 (CI)。 根据纳入和排除标准,共有 26 项研究纳入本荟萃分析。年龄、原发性心血管疾病、糖尿病和高水平碱性磷酸酶与 PD 患者全因和心血管死亡率升高显著相关,而血红蛋白则是一个有益因素。此外,腹膜炎的早期发作、高腹膜转运状态、较高的体重指数和高敏 C 反应蛋白也会显著增加全因死亡率的风险。进一步需要验证改善 PD 患者生存所需的血清镁、钾和尿酸的绝对水平。 多种因素可能会影响 PD 患者的死亡风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc7b/8901278/c5ee2d28e12c/IRNF_A_1918558_F0001_B.jpg

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