透析不足:决定因素和临床相关性——尼日利亚一项双中心回顾性研究的结果

P. Uduagbamen, F. Soyinka, T. Binuyo, N. Boco
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引用次数: 0

摘要

背景:为了提供足够的透析剂量,有必要优化透析频率、红细胞生成素的使用、血压控制等。这是除了治疗合并症和尽量减少并发症之外的。充分的透析可以提高生活质量,降低发病率和死亡率。目的:评估这两个中心透析不足的决定因素和相关性。材料和方法:我们分析了来自尼日利亚两个中心的623名终末期肾病参与者接受的5065种常见透析治疗。分析了每周一次、两次和三次治疗的参与者的生物数据、血清生物化学和红细胞压积。结果:男性比女性接受更多的透析治疗。227名(36.4%)患者每周进行一次治疗,296名(47.5%)患者每周两次治疗,100名(16.1%)患者每周三次治疗。所有参与者的平均年龄为50.5±7.9岁,女性高于男性,P=0.02。老年人在维持性透析人群中的比例为13.8%。只有19.4%的参与者符合肾脏疾病结果质量倡议关于每周三次红细胞生成素的建议,而只有11.9%的参与者有健康保险。男性的透析剂量更高(P=0.07),有健康保险(P<0.001),经常透析(P<0.001。透析终止和透析中死亡与透析频率呈负相关。健康保险、透析频率和红细胞生成素预测了透析剂量。结论:透析人群中普遍存在透析不足和红细胞生成素使用不理想的情况,这限制了处方剂量,最终导致透析剂量较低,透析并发症较高,生活质量较差。
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Under-Dialysis: Determinants and clinical correlates – Findings from a two-centre retrospective study in Nigeria
Background: To deliver an adequate dialysis dose, it is necessary that the dialysis frequency, erythropoietin use, blood pressure control among others, be optimized. This is in addition to treating comorbidities and minimizing complications. Adequate dialysis improves the quality of life (QOL) and reduces the morbidity and mortality rates. Aim: To assess the determinant and correlates of under-dialysis in these two centres. Materials and Methods: We analyzed 5065 prevalent dialysis treatments given to 623 participants with end-stage renal disease from two centres in Nigeria. Participants' biodata, serum biochemistry, and hematocrit of cohorts with once-, twice-, and thrice-weekly sessions were analyzed. Results: Males had more dialysis treatments than women. Two hundred and twenty-seven (36.4%) cohorts had weekly sessions, 296 (47.5%) had twice-weekly sessions, and 100 (16.1%) had thrice-weekly sessions. The mean age of all participants was 50.5 ± 7.9 years, and was higher in women than men, P = 0.02. The percentage of the elderly in the maintenance dialysis population was 13.8%. Only 19.4% of the participants meet the Kidney Disease Outcomes Quality Initiative recommendation of thrice-weekly erythropoietin, just as only 11.9% had health insurance. The dialysis dose was higher in males (P = 0.07), with health insurance (P < 0.001), frequent dialysis (P < 0.001), frequent erythropoietin (P < 0.001), higher hematocrit (P = 0.03), and bicarbonate (P = 0.001), but was lower in intradialytic hypotension compared to intradialytic hypertension, P = 0.004 versus P = 0.005. Dialysis termination and intradialytic death were negatively correlated with dialysis frequency. Health insurance, frequency of dialysis, and erythropoietin predicted the dialysis dose. Conclusion: Under-dialysis and suboptimal erythropoietin use were prevalent in the dialysis population and it restricted the prescribed dose which eventually gave lower dialysis doses, higher dialysis complications, and poor QOL.
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来源期刊
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0.00%
发文量
65
审稿时长
20 weeks
期刊介绍: The Nigerian Journal of Medicine publishes articles on socio-economic, political and legal matters related to medical practice; conference and workshop reports and medical news.
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