聚蔗糖对新发腹膜透析患者结局的影响。
The impact of icodextrin on the outcomes of incident peritoneal dialysis patients.
机构信息
Divisions of Nephrology, China Medical University Hospital, Taichung, Taiwan.
Department of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
出版信息
PLoS One. 2024 Mar 29;19(3):e0297688. doi: 10.1371/journal.pone.0297688. eCollection 2024.
OBJECTIVE
The aim of the study is to investigate the effects of icodextrin on the risks of death, technique failure and the first episode of peritonitis in peritoneal dialysis (PD) patients.
METHODS
From medical records of a medical center in Taiwan, a total of 725 newly diagnosed end-stage kidney disease patients receiving PD for at least 90 days from January 1, 2007 to December 31, 2018 were identified. These patients were grouped as 190 icodextrin users and 535 non-users. Users were defined as utilization of icodextrin for ≥ 50% of their PD duration. The use of icodextrin was considered a time-varying exposure in the Cox proportional hazard model. The risks of death, technique failure and the first episode of peritonitis were compared between two cohorts by the end of 2018.
RESULTS
Compared to the non-users, the icodextrin users had significant lower risks of mortality (6.5 vs.7.2 per 100 person-years; adjusted HR = 0.62, 95% CI = 0.42-0.91) and technique failure (12.7 vs. 15.2 per 100 person-years; adjusted HR = 0.61, 95% CI = 0.47-0.81), and the first peritonitis episode (5.0 vs. 17.0 per 100 person-years; adjusted HR = 0.22, 95% CI = 0.14-0.35). The risk of peritonitis reduced further in icodextrin users with diabetes and with cardiovascular disease.
CONCLUSION
Icodextrin was associated with lower risks of mortality, technique failure, and the first episode of peritonitis.
目的
本研究旨在探讨艾考糊精对腹膜透析（PD）患者死亡、技术失败和首次腹膜炎发作风险的影响。
方法
从台湾一家医学中心的病历记录中，共确定了 725 名 2007 年 1 月 1 日至 2018 年 12 月 31 日期间至少接受 PD 治疗 90 天的新诊断为终末期肾病的患者。这些患者被分为 190 名艾考糊精使用者和 535 名非使用者。使用者被定义为 PD 期间使用艾考糊精的时间占比≥50%。在 Cox 比例风险模型中，艾考糊精的使用被视为一个时变暴露。通过 2018 年底比较两组患者的死亡、技术失败和首次腹膜炎发作风险。
结果
与非使用者相比，艾考糊精使用者的死亡率（每 100 人年 6.5 例 vs. 7.2 例；调整后的 HR = 0.62，95%CI = 0.42-0.91）和技术失败率（每 100 人年 12.7 例 vs. 15.2 例；调整后的 HR = 0.61，95%CI = 0.47-0.81）较低，首次腹膜炎发作率（每 100 人年 5.0 例 vs. 17.0 例；调整后的 HR = 0.22，95%CI = 0.14-0.35）较低。在患有糖尿病和心血管疾病的艾考糊精使用者中，腹膜炎的风险进一步降低。
结论
艾考糊精与较低的死亡率、技术失败率和首次腹膜炎发作风险相关。
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