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老年腹膜透析患者早发性腹膜炎的临床转归较差:一项纵向和多中心研究。

Poorer clinical outcomes of early-onset peritonitis in elderly peritoneal dialysis patients: A longitudinal and multicenter study.

机构信息

Department of Nephrology, The Second Hospital of Jilin University, Changchun, Jilin, China.

Department of Nephrology, Jilin FAW General Hospital, Changchun, Jilin, China.

出版信息

Ther Apher Dial. 2022 Aug;26(4):815-821. doi: 10.1111/1744-9987.13762. Epub 2021 Dec 1.

Abstract

INTRODUCTION

Early-onset peritonitis (EOP) is a risk factor for mortality in peritoneal dialysis (PD) patients. This study investigates the clinical features and outcomes of EOP in elderly patients.

METHODS

This multicenter retrospective study evaluated 433 elderly PD patients with end-stage renal disease. The cohort was divided into nonperitonitis group (n = 239), EOP group (≤12 months, n = 109) and late-onset peritonitis (LOP) group (>12 months, n = 85). Clinical data, treatment results, and outcomes were compared between the groups.

RESULTS

Compared with LOP group, there were no significant intergroup differences in the rate of primary recovery, complete cure, relapse, catheter removal, or death from PDAP (p >0.05) in the most recent PDAP episode. However, Kaplan-Meier analysis showed that patients in the EOP group were likely to have multiple episodes of PD-associated peritonitis (PDAP), technique failure, all-cause death, and composite endpoint in the long-term prognostic outcomes (p <0.001).

CONCLUSIONS

EOP is significantly associated with poorer clinical outcomes in older PD patients.

摘要

简介

早发性腹膜炎(EOP)是腹膜透析(PD)患者死亡的一个危险因素。本研究调查了老年 PD 患者 EOP 的临床特征和结局。

方法

这是一项多中心回顾性研究,评估了 433 名终末期肾病的老年 PD 患者。该队列分为非腹膜炎组(n=239)、EOP 组(≤12 个月,n=109)和迟发性腹膜炎(LOP)组(>12 个月,n=85)。比较了各组的临床数据、治疗结果和结局。

结果

与 LOP 组相比,在最近一次 PDAP 发作中,EOP 组的原发性恢复率、完全治愈率、复发率、导管移除率或 PDAP 相关死亡率(p>0.05)无显著差异。然而,Kaplan-Meier 分析表明,EOP 组患者在长期预后结局中更有可能发生多次 PDAP 发作、技术失败、全因死亡和复合终点(p<0.001)。

结论

EOP 与老年 PD 患者的临床结局较差显著相关。

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