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老年患者持续非卧床腹膜透析的生存率

Survival Rates in Elderly Patients on Continuous Ambulatory Peritoneal Dialysis.

作者信息

Nguyen Bach, Bui Quynh Thi Huong, Tran Phuong Que

机构信息

Department of Nephrology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam.

Department of Clinical Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

出版信息

Int J Nephrol Renovasc Dis. 2023 Apr 19;16:131-141. doi: 10.2147/IJNRD.S397555. eCollection 2023.

Abstract

PURPOSE

The present study aimed at evaluating the survival rate, its associated factors, and the causes of death in elderly patients undergoing continuous ambulatory peritoneal dialysis (CAPD) in Vietnam.

PATIENTS AND METHODS

This is a retrospective, observational study conducted among patients aged ≥65 years who underwent CAPD at Thong Nhat Hospital, Ho Chi Minh City, Vietnam, from April 2012 to December 2020. The Kaplan-Meier method was used to calculate the cumulative survival rate, and the Log rank test was used to analyze the factors associated with the survival rate of patients.

RESULTS

This study enrolled a total of 68 patients with a mean age of 71.93 ± 7.44 years at the initiation of CAPD. The most common complication among kidney failure patients was diabetic nephropathy (39.71%). The rate of concomitant cardiovascular diseases was 58.82%. The average survival rate was 45.59 ± 4.01 months. Peritonitis was the most common factor causing death (31.25%), followed by cardiovascular diseases (28.12%) and malnutrition (25%). The factors that impacted the survival rate included concomitant cardiovascular diseases, low serum albumin (<35 g/dL), and an indication of CAPD due to exhausted vascular access for hemodialysis at baseline. The main factor associated with a shorter survival time was concomitant cardiovascular diseases.

CONCLUSION

It is necessary to improve the survival time beyond 5 years for elderly patients undergoing CAPD, especially for those with concomitant cardiovascular diseases. Besides the prevention of peritonitis, adequate measures to protect from cardiovascular diseases and malnutrition will reduce the mortality rate in patients on CAPD.

摘要

目的

本研究旨在评估越南接受持续性非卧床腹膜透析(CAPD)的老年患者的生存率、相关因素及死亡原因。

患者与方法

这是一项回顾性观察研究,对象为2012年4月至2020年12月期间在越南胡志明市统一医院接受CAPD治疗的≥65岁患者。采用Kaplan-Meier法计算累积生存率,并用Log rank检验分析与患者生存率相关的因素。

结果

本研究共纳入68例患者,开始CAPD时的平均年龄为71.93±7.44岁。肾衰竭患者中最常见的并发症是糖尿病肾病(39.71%)。心血管疾病的合并率为58.82%。平均生存率为45.59±4.01个月。腹膜炎是最常见的死亡原因(31.25%),其次是心血管疾病(28.12%)和营养不良(25%)。影响生存率的因素包括合并心血管疾病、血清白蛋白低(<35 g/dL)以及基线时因血液透析血管通路耗竭而进行CAPD的指征。与较短生存时间相关的主要因素是合并心血管疾病。

结论

有必要提高接受CAPD治疗的老年患者的生存时间至5年以上,尤其是合并心血管疾病的患者。除了预防腹膜炎外,采取适当措施预防心血管疾病和营养不良将降低CAPD患者的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ff0/10122850/4307521be26e/IJNRD-16-131-g0001.jpg

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