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长期中心夜间血液透析可改善老年慢性肾衰竭患者的肾功能贫血、营养不良和生活质量。

Long-Term In-Center Nocturnal Hemodialysis Improves Renal Anemia and Malnutrition and Life Quality of Older Patients with Chronic Renal Failure.

机构信息

Department of Internal Medicine, Division of Nephrology, Telemedicine Center, Shanghai Municipal Eighth People's Hospital, Shanghai, People's Republic of China.

Department of Internal Medicine, Division of Nephrology, Shanghai Changzheng Hospital, Shanghai, People's Republic of China.

出版信息

Clin Interv Aging. 2022 Jun 3;17:915-923. doi: 10.2147/CIA.S358472. eCollection 2022.

Abstract

BACKGROUND

Older patients with chronic renal failure (CRF) which currently is referred to as end-stage renal disease (ESRD) are associated with higher mortality. In-center nocturnal dialysis (INHD) is a new blood purification model, which is characterized by longer sessions and nighttime administration. However, no data for the efficacy of INHD in older patients with ESRD are available. This study is to analyze the effect of INHD in the treatment of older patients with ESRD.

METHODS

A retrospective, observational study was conducted in a university teaching hospital. Seventy-two patients with ESRD receiving INHD were enrolled. They were divided into the older ESRD patients (age ≥60) group (n = 22) and the non-older ESRD patients (age <60) group (n = 50). The causes of older ESRD patients and non-older ESRD patients receiving INHD were analyzed. Differences of laboratory test indicators of older patients with ESRD before INHD and after INHD were compared. Quality of life for older ESRD patients receiving INHD was assessed by using the Kidney Disease Quality of Life-36 Instrument (KDQOL-36).

RESULTS

Serum concentration of hemoglobin and serum concentration of albumin of older patients with ESRD increased significantly after INHD ( < 0.05). There were similar results in the non-older cohort ( ≤ 0.05). Scores of five KDQOL-36 subscales increased significantly after INHD ( ≤ 0.001) indicated that the quality of life for old patients with ESRD was significantly improved after INHD.

CONCLUSION

INHD is an effective blood purification therapy that can improve the condition of renal anemia, and it may provide a potential positive impact in the malnutrition of older and non-older patients with ESRD. INHD can improve the quality of life of older patients with ESRD. The results will provide a basis for formulating new policies of blood purification therapy for older patients.

摘要

背景

患有慢性肾衰竭(CRF)的老年患者(目前称为终末期肾病(ESRD))死亡率较高。中心夜间透析(INHD)是一种新的血液净化模式,其特点是治疗时间更长且在夜间进行。然而,目前尚无 INHD 治疗 ESRD 老年患者疗效的数据。本研究旨在分析 INHD 在治疗 ESRD 老年患者中的作用。

方法

在一所大学教学医院进行了回顾性、观察性研究。共纳入 72 名接受 INHD 的 ESRD 患者。他们被分为老年 ESRD 患者(年龄≥60 岁)组(n=22)和非老年 ESRD 患者(年龄<60 岁)组(n=50)。分析了老年和非老年 ESRD 患者接受 INHD 的原因。比较了老年 ESRD 患者 INHD 前后实验室检查指标的差异。采用肾脏病生活质量-36 量表(KDQOL-36)评估接受 INHD 的老年 ESRD 患者的生活质量。

结果

INHD 后老年 ESRD 患者的血清血红蛋白浓度和血清白蛋白浓度显著升高(<0.05)。非老年组也有类似结果(≤0.05)。INHD 后,KDQOL-36 五个子量表的评分均显著升高(≤0.001),表明 INHD 可显著改善老年 ESRD 患者的生活质量。

结论

INHD 是一种有效的血液净化治疗方法,可改善肾性贫血状况,可能对老年和非老年 ESRD 患者的营养不良产生潜在积极影响。INHD 可提高老年 ESRD 患者的生活质量。这些结果将为制定老年患者血液净化治疗新政策提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8757/9172732/d4ec5c760854/CIA-17-915-g0001.jpg

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