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首页> 外文期刊>Peritoneal dialysis international: Journal of the International Society for Peritoneal Dialysis >Improvement in clinical outcome by early nephrology referral in type II diabetics on maintenance peritoneal dialysis.
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Improvement in clinical outcome by early nephrology referral in type II diabetics on maintenance peritoneal dialysis.

机译：通过维持性腹膜透析在II型糖尿病患者中早期肾脏病转诊改善临床结局。

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摘要

OBJECTIVES: To evaluate the influence of early nephrology referral on clinical outcome in type II diabetes mellitus patients on maintenance peritoneal dialysis (PD). DESIGN: This is a retrospective study in a single University Hospital in Taiwan. PATIENTS: This study analyzed the type II diabetic patients entering our PD program from February 1988 to June 2000. Patients that were presented to a nephrologist more than 6 months before starting dialysis were defined as early referrals (ER). Patients were considered late referrals (LR) if they were transferred to the nephrology department within 6 months before initial dialysis. MAIN OUTCOME MEASURES: Patient survival and technique survival curves were derived from Kaplan-Meier analysis and were compared using the Cox-Mantel log rank test. Covariates were analyzed with Cox proportional hazards model. RESULTS: 52 type II diabetic patients were enrolled in this study: 16 in the ER group and 36 in the LR group. Patient survival was better in the ER group thanin the LR group [relative risks [exp(coef)] 0.42; 95% confidence interval 0.152-0.666; p < 0.05]. The improved survival in the ER group was independent of age at dialysis, good glycemic control, and residual renal function, as indicated in the multivariate analysis with stepwise regression by Cox proportional hazards model. The ER group was also associated with better technique survival. CONCLUSIONS: These results suggest that early nephrology referral before initiating dialysis is associated with improved long-term clinical outcome in type II diabetics on maintenance PD.
机译：目的：评估早期肾脏病转诊对维持性腹膜透析（PD）II型糖尿病患者临床结局的影响。设计：这是在台湾一家大学医院进行的回顾性研究。患者：这项研究分析了从1988年2月至2000年6月进入我们的PD计划的II型糖尿病患者。在开始透析前6个月以上就诊给肾脏科医生的患者被定义为早期转诊（ER）。如果患者在初次透析前6个月内被转诊至肾脏科，则被视为晚期转诊（LR）。主要观察指标：患者生存期和技术生存期曲线来自Kaplan-Meier分析，并使用Cox-Mantel对数秩检验进行比较。使用Cox比例风险模型分析协变量。结果：52例II型糖尿病患者被纳入本研究：ER组16例，LR组36例。 ER组的患者生存率优于LR组[相对风险[exp（coef）] 0.42; 95％置信区间0.152-0.666; p ＜0.05]。 ER组的改善生存率与透析年龄，良好的血糖控制和残余肾功能无关，如通过Cox比例风险模型逐步回归的多变量分析所示。 ER组也与更好的技术存活率相关。结论：这些结果表明，在维持透析的II型糖尿病患者中，在开始透析前及早转诊肾病与改善长期临床结局有关。

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