...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Peritoneal dialysis international: Journal of the International Society for Peritoneal Dialysis >Rate of decline of residual renal function in patients on continuous peritoneal dialysis and factors affecting it.
【24h】

Rate of decline of residual renal function in patients on continuous peritoneal dialysis and factors affecting it.

机译：持续腹膜透析患者残余肾功能的下降率及其影响因素。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: We analyzed residual renal function (RRF) in a large number of new peritoneal dialysis (PD) patients to prospectively define the time course of decline of RRF and to evaluate the risk factors assumed to be associated with faster decline. STUDY DESIGN: Single-center, prospective cohort study. SETTING: Home PD unit of a tertiary care University Hospital. PATIENTS: The study included 242 patients starting continuous PD between January 1994 and December 1997, with a minimum follow-up of 6 months and at least three measurements of RRF. MEASUREMENT: All patients had data on demographic and laboratory variables, episodes of peritonitis and the use of aminoglycoside (AG) antibiotics, temporary hemodialysis, and number of radiocontrast studies. Adequacy of PD was measured from 24-hour urine and dialysate collection and peritoneal equilibration test using standard methodology. Further data on RRF was collected every 3 to 4 months until the patient became anuric (urine volume < 100 mL/day or creatinine clearance < 1.0 mL/min) or until the end of study in December 1998. OUTCOME MEASURE: The slope of the decline of residual glomerular filtration rate (GFR) (an average of renal urea and creatinine clearance) was the main outcome measure. Risk factors associated with faster decline were evaluated by a comparative analysis between patients in the highest and the lowest quartiles of the slopes of GFR, and a multivariate analysis using a stepwise option within linear regression and general linear models. RESULTS: There was a gradual deterioration of residual GFR with time on PD, with 40% of patients developing anuria at a mean of 20 months after the initiation of PD. On multivariate analysis, use of a larger volume of dialysate (p = 0.0001), higher rate of peritonitis (p = 0.0005), higher use of AG (p = 0.0006), presence of diabetes mellitus (p = 0.005), larger body mass index (BMI) (p = 0.01), and no use of antihypertensive medications (p = 0.04) independently predicted the steep slope of residual GFR. Male gender, higher grades of left ventricular dysfunction, and higher 24-hour proteinuria were associated with faster decline on univariate analysis only. CONCLUSION: Faster decline of residual GFR corresponds with male gender, large BMI, presence of diabetes mellitus, higher grades of congestive heart failure, and higher 24-hour proteinuria. Higher rate of peritonitis and use of AG for the treatment of peritonitis is also associated independently with faster decline of residual GFR. Whether the type of PD (CAPD vs CCPD/NIPD) is associated with faster decline of residual GFR remains speculative.
机译：目的：我们分析了许多新腹膜透析（PD）患者的残余肾功能（RRF），以明确定义RRF下降的时间过程，并评估被认为与下降更快有关的危险因素。研究设计：单中心，前瞻性队列研究。地点：三级护理大学医院的家庭PD单元。患者：该研究纳入了242例从1994年1月至1997年12月开始连续性PD的患者，至少随访6个月，至少进行了3次RRF测量。测量：所有患者均具有人口统计学和实验室变量，腹膜炎发作和使用氨基糖苷（AG）抗生素的使用，临时性血液透析以及放射性对比研究的数据。使用标准方法从24小时尿液和透析液收集以及腹膜平衡测试中测量PD的充足性。每3到4个月收集有关RRF的更多数据，直到患者出现无尿（尿量<100 mL /天或肌酐清除率<1.0 mL / min）或直到1998年12月研究结束为止。残余肾小球滤过率（GFR）（肾尿素和肌酐清除率的平均值）下降是主要的结局指标。通过比较GFR斜率最高和最低四分位数的患者之间的比较分析，以及在线性回归和一般线性模型中使用逐步选项的多变量分析，评估了与快速下降相关的风险因素。结果：PD的残留GFR随时间逐渐降低，其中40％的患者在开始PD的平均20个月后出现无尿。在多变量分析中，使用较大量的透析液（p = 0.0001），腹膜炎发生率较高（p = 0.0005），使用AG较多（p = 0.0006），存在糖尿病（p = 0.005），体重较大指数（BMI）（p = 0.01），并且未使用降压药（p = 0.04）独立预测残留GFR的陡峭斜率。男性，左心功能不全的等级较高和24小时蛋白尿的增加仅与单因素分析的下降较快有关。结论：残余GFR的下降较快与男性，体重指数（BMI）大，糖尿病的存在，充血性心力衰竭的等级较高和24小时蛋白尿有关。较高的腹膜炎发生率和使用AG来治疗腹膜炎也与残留GFR的下降更快相关。 PD的类型（CAPD与CCPD / NIPD）是否与残留GFR的更快下降相关，尚不确定。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号