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为什么我们没有让更多患者接受腹膜透析?来自美国的观察及其全球影响。

Why are we Not Getting More Patients onto Peritoneal Dialysis? Observations From the United States with Global Implications.

作者信息

Teitelbaum Isaac, Finkelstein Frederic O

机构信息

Division of Kidney Diseases and Hypertension, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.

Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut, USA.

出版信息

Kidney Int Rep. 2023 Jul 25;8(10):1917-1923. doi: 10.1016/j.ekir.2023.07.012. eCollection 2023 Oct.

DOI:10.1016/j.ekir.2023.07.012
PMID:37849989
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10577320/
Abstract

Peritoneal dialysis (PD) offers lifestyle advantages over in-center hemodialysis (HD) and is less costly. However, in the United States, less than 12% of end-stage kidney disease (ESKD) patients are maintained on this modality. In this brief review, we discuss some of the factors underlying the low prevalence of PD. These include inadequate patient education, a shortage of sufficiently well-trained medical and nursing personnel, absence of infrastructure to support urgent start PD, and lack of support for assisted PD, among other factors. Understanding and addressing these various issues may help increase the prevalence of PD in the United States and globally.

摘要

腹膜透析(PD)相较于中心血液透析(HD)具有生活方式上的优势,且成本更低。然而,在美国,终末期肾病(ESKD)患者中接受这种透析方式的不到12%。在这篇简短的综述中,我们讨论了导致PD低普及率的一些因素。这些因素包括患者教育不足、缺乏训练有素的医护人员、缺乏支持紧急开始PD的基础设施以及对辅助PD缺乏支持等。了解并解决这些各种问题可能有助于提高PD在美国乃至全球的普及率。

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Kidney Med. 2023 Mar 20;5(5):100629. doi: 10.1016/j.xkme.2023.100629. eCollection 2023 May.
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US Renal Data System 2022 Annual Data Report: Epidemiology of Kidney Disease in the United States.美国肾脏数据系统2022年年报:美国肾脏疾病流行病学
Am J Kidney Dis. 2023 Mar;81(3 Suppl1):A8-A11. doi: 10.1053/j.ajkd.2022.12.001.
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Home dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.家庭透析:改善全球肾脏病预后组织(KDIGO)争议会议的结论。
Kidney Int. 2023 May;103(5):842-858. doi: 10.1016/j.kint.2023.01.006. Epub 2023 Jan 31.
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Financial Incentives to Facilities and Clinicians Treating Patients With End-stage Kidney Disease and Use of Home Dialysis: A Randomized Clinical Trial.为治疗终末期肾病患者并使用居家透析的医疗机构和临床医生提供经济激励:一项随机临床试验。
JAMA Health Forum. 2022 Oct 7;3(10):e223503. doi: 10.1001/jamahealthforum.2022.3503.
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