Zhao Xinju, Ma Chengqian, Gan Liangying, Hou Fan Fan, Liang Xinling, Chen Xiaonong, Ni Zhaohui, Chen Yuqing, Li Xue, Guo Wudong, Zuo Li
Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building, 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China.
Division of Nephrology, Nanfang Hospital, National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, China.
Sci Rep. 2025 Aug 4;15(1):28428. doi: 10.1038/s41598-025-11951-6.
The prevalence of hemodialysis (HD) patients in China is escalating, necessitating a comprehensive understanding of their clinical profiles. This study offers an in-depth analysis of the baseline data from the China Dialysis Outcomes and Practice Patterns Study (DOPPS) Phase 7 (DOPPS7), aiming to assess the current clinical characteristics and target ranges for the most recent years. It also compares these findings with those from DOPPS Phase 5. The DOPPS is a well-regarded international, prospective, and observational cohort study. Our analysis focused on the initial sample of patients enrolled in China DOPPS7. We report the demographic and clinical characteristics of 1843 patients, with a mean age of 61 ± 14 years and a male predominance (60.7%). The median dialysis vintage was 2.64 years, with diabetes (31.7%) and chronic glomerulonephritis (21.4%) being the leading causes of end-stage kidney disease (ESKD). Notably, 81.2% of patients had a single-pooled Kt/V ≥ 1.2, and 80.5% maintained albumin levels > 3.5 g/dl. Hemoglobin levels within the target range (110-130 g/dl) were observed in 44.2% of patients, while serum calcium (8.4-10.2 mg/dl) and phosphate (3.5-5.5 mg/dl) were within target ranges in 63.8% and 38.3% of patients, respectively. PTH levels were maintained within 150-600 pg/dl in 57.6% of patients, and 84.7% utilized fistula as their vascular access. Significant variations were noted in demographic, clinical, laboratory, and treatment characteristics among the three cities involved in the study. Compared to DOPPS5, improvements were observed in the proportion of patients meeting standards for hemoglobin, blood phosphorus, iPTH, and spKTV, while serum calcium, TSAT, and ferritin levels remained relatively stable. However, an increase in the proportion of patients with albumin < 3.5 g/dl was noted. The study's limitations include the exclusion of patients from smaller cities and remote areas, where HD patient conditions might differ significantly from those reported.
中国血液透析（HD）患者的患病率正在上升，因此有必要全面了解他们的临床特征。本研究对中国透析结局与实践模式研究（DOPPS）第7阶段（DOPPS7）的基线数据进行了深入分析，旨在评估近年来的当前临床特征和目标范围。它还将这些结果与DOPPS第5阶段的结果进行了比较。DOPPS是一项备受认可的国际性、前瞻性观察性队列研究。我们的分析集中在中国DOPPS7纳入的初始患者样本。我们报告了1843例患者的人口统计学和临床特征，平均年龄为61±14岁，男性占主导（60.7%）。透析中位时间为2.64年，糖尿病（31.7%）和慢性肾小球肾炎（21.4%）是终末期肾病（ESKD）的主要原因。值得注意的是，81.2%的患者单次Kt/V≥1.2，80.5%的患者白蛋白水平>3.5g/dl。44.2%的患者血红蛋白水平在目标范围内（110 - 130g/dl），而血清钙（8.4 - 10.2mg/dl）和磷酸盐（3.5 - 5.5mg/dl）分别在63.8%和38.3%的患者中处于目标范围内。57.6%的患者甲状旁腺激素（PTH）水平维持在150 - 600pg/dl，84.7%的患者使用动静脉内瘘作为血管通路。研究涉及的三个城市在人口统计学、临床、实验室和治疗特征方面存在显著差异。与DOPPS5相比，达到血红蛋白、血磷、全段甲状旁腺激素（iPTH）和标准化Kt/V标准的患者比例有所改善，而血清钙、转铁蛋白饱和度（TSAT）和铁蛋白水平保持相对稳定。然而，白蛋白<3.5g/dl的患者比例有所增加。该研究的局限性包括排除了来自小城市和偏远地区的患者，这些地区HD患者的情况可能与报告的情况有显著差异。
