...
  • 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 >Impact of global economic disparities on practices and outcomes of chronic peritoneal dialysis in children: Insights from the international pediatric peritoneal dialysis network registry
【24h】

Impact of global economic disparities on practices and outcomes of chronic peritoneal dialysis in children: Insights from the international pediatric peritoneal dialysis network registry

机译：全球经济差异对儿童慢性腹膜透析的做法和结果的影响：国际儿科腹膜透析网络注册处的见解

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

Background, Objectives, and Methods: The number of patients on chronic peritoneal dialysis (CPD) is increasing rapidly on a global scale. We analyzed the International Pediatric Peritoneal Dialysis Network (IPPN) registry, a global database active in 33 countries spanning a wide range in gross national income (GNI), to identify the impact of economic conditions on CPD practices and outcomes in children and adolescents. Results: We observed close associations of GNI with the fraction of very young patients on dialysis, the presence and number of comorbidities, the prevalence of patients with unexplained causes of end-stage kidney disease, and the rate of culture-negative peritonitis. The prevalence of automated PD increased with GNI, but was 46% even in the lowest GNI stratum. The GNI stratum also affected the use of biocompatible peritoneal dialysis fluids, enteral tube feeding, calcium-free phosphate binders, active vitamin D analogs, and erythropoiesis-stimulating agents (ESAs). Patient mortality was strongly affected by GNI (hazard ratio per $10 000: 3.3; 95% confidence interval: 2.0 to 5.5) independently of young patient age and the number of comorbidities present. Patients from low-income countries tended to die more often from infections unrelated to CPD (5 of 9 vs 15 of 61, p = 0.1). The GNI was also a strong independent predictor of standardized height (p < 0.0001), adding to the impact of congenital renal disease, anuria, age at PD start, and dialysis vintage. Patients from the lower economic strata (GNI < $18 000) had higher serum parathyroid hormone (PTH) and lower serum calcium, and achieved lower hemoglobin concentrations. No impact of GNI was observed with regard to CPD technique survival or peritonitis incidence. {black diamond suit} Conclusions: We conclude that CPD is practiced successfully, albeit with major regional variation related to economic differences, in children around the globe. Thevariations encompass the acceptance of very young patients and those with associated comorbidities to chronic dialysis programs, the use of automated PD and expensive drugs, and the diagnostic management of peritonitis. These variations in practice related to economic difference do not appear to affect PD technique survival; however, economic conditions seem to affect mortality on dialysis and standardized height, a marker of global child morbidity.
机译：背景，目的和方法：慢性腹膜透析（CPD）的患者数量在全球范围内正在迅速增加。我们分析了国际儿科腹膜透析网络（IPPN）注册表，该数据库是活跃于33个国家/地区的全球数据库，其国民总收入（GNI）范围很广，以确定经济状况对CPD做法和儿童和青少年结局的影响。结果：我们观察到GNI与非常年轻的透析患者比例，合并症的存在和数量，未明原因的终末期肾脏疾病患者的患病率以及培养阴性腹膜炎的发生率密切相关。自动化PD的患病率随GNI的增加而增加，但即使在最低的GNI阶层中也为46％。 GNI层还影响了生物相容性腹膜透析液，肠管饲喂，无钙磷酸盐结合剂，活性维生素D类似物和促红细胞生成剂（ESA）的使用。 GNI（每10 000美元的危险比：3.3; 95％置信区间：2.0至5.5）对患者的死亡率有很大影响，而与年轻患者的年龄和合并症的数量无关。来自低收入国家的患者往往死于与CPD无关的感染（9人中的5人vs 61人中的15人，p = 0.1）。 GNI还是标准身高（p <0.0001）的有力独立预测指标，增加了先天性肾脏疾病，无尿症，PD开始年龄和透析年龄的影响。来自较低经济阶层（GNI <$ 18 000）的患者血清甲状旁腺激素（PTH）较高，血清钙较低，血红蛋白浓度较低。对于CPD技术的存活率或腹膜炎的发生率，未观察到GNI的影响。 {黑钻石套装}结论：我们得出的结论是，尽管CPD成功地在全球儿童中实施，尽管与经济差异相关的地区差异很大。变化包括接受非常年轻的患者以及具有慢性透析程序相关合并症的患者，使用自动化PD和昂贵的药物以及腹膜炎的诊断管理。与经济差异有关的实践中的这些变化似乎并不影响PD技术的生存;然而，经济状况似乎会影响透析和标准身高的死亡率，而身高和身高是全球儿童发病率的标志。

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