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老年与非老年患者腹膜透析的结局比较：系统评价和荟萃分析。

Outcomes of peritoneal dialysis in elderly vs non-elderly patients: A systemic review and meta-analysis.

机构信息

Department of nephrology, The affiliated People's Hospital with Jiangsu University, Zhenjiang, Jiangsu, P.R.China.

出版信息

PLoS One. 2022 Feb 8;17(2):e0263534. doi: 10.1371/journal.pone.0263534. eCollection 2022.

DOI:10.1371/journal.pone.0263534
PMID:35134073
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8824377/
Abstract

OBJECTIVES

Several studies have compared outcomes of peritoneal dialysis (PD) between elderly and non-elderly patients but with variable results. We hereby designed this review to compare mortality, peritonitis, and technique survival between elderly and non-elderly patients on PD.

METHODS

PubMed, Embase, and Google Scholar were searched for studies comparing outcomes of PD between elderly and non-elderly patients. The last search date was 14th July 2021.

RESULTS

Fourteen studies were included. 12 studies defined the elderly as ≥65 years of age and these were included in the meta-analysis. Pooled analysis of crude (RR: 2.45 95% CI: 1.36, 4.40 I2 = 97% p = 0.003) and adjusted data (HR: 2.80 95% CI: 2.45, 3.09 I2 = 0% p<0.00001) indicated a statistically significant increased risk of mortality amongst elderly patients as compared to non-elderly patients. Meta-analysis of four studies demonstrated a statistically significant increased risk of peritonitis in the elderly (RR: 1.56 95% CI: 1.18, 2.07 I2 = 76% p = 0.002). Pooled analysis demonstrated no statistically significant difference in technique survival between the two groups (RR: 0.95 95% CI: 0.86, 1.05 I2 = 86% p = 0.32).

CONCLUSION

Elderly patients on PD have a significantly increased risk of mortality as compared to non-elderly patients. The risk of peritonitis is also significantly increased in older adults but the increased age has no impact on technique survival. Further studies are needed to strengthen our conclusions.

摘要

目的

已有多项研究比较了老年和非老年腹膜透析（peritoneal dialysis，PD）患者的结局，但结果存在差异。因此，我们设计了这项综述来比较 PD 患者的死亡率、腹膜炎和技术生存率在老年和非老年患者之间的差异。

方法

我们在 PubMed、Embase 和 Google Scholar 上检索了比较老年和非老年 PD 患者结局的研究。最后一次检索日期为 2021 年 7 月 14 日。

结果

共纳入 14 项研究。其中 12 项研究将老年定义为≥65 岁，并纳入了荟萃分析。荟萃分析显示，两组间死亡率的粗率（RR：2.45，95%CI：1.36，4.40 I2 = 97%，p = 0.003）和调整后数据（HR：2.80，95%CI：2.45，3.09 I2 = 0%，p<0.00001）差异均有统计学意义，提示老年患者的死亡率明显高于非老年患者。四项研究的荟萃分析表明，老年患者发生腹膜炎的风险显著增加（RR：1.56，95%CI：1.18，2.07 I2 = 76%，p = 0.002）。两组间技术生存率的差异无统计学意义（RR：0.95，95%CI：0.86，1.05 I2 = 86%，p = 0.32）。

结论

与非老年 PD 患者相比，老年 PD 患者的死亡率显著增加。老年患者发生腹膜炎的风险也显著增加，但年龄增加对技术生存率没有影响。需要进一步的研究来加强我们的结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8d4/8824377/e865e3fde938/pone.0263534.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8d4/8824377/113b85e3c6e9/pone.0263534.g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8d4/8824377/e865e3fde938/pone.0263534.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8d4/8824377/113b85e3c6e9/pone.0263534.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8d4/8824377/eabdeaafe4ce/pone.0263534.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8d4/8824377/8ca779f1cae4/pone.0263534.g003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8d4/8824377/e865e3fde938/pone.0263534.g005.jpg

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