A comparison of persons who present for preemptive and nonpreemptive kidney transplantation.
A comparison of persons who present for preemptive and nonpreemptive kidney transplantation.
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进行先发性肾移植和非先发性肾移植的患者的比较。
DOI：
10.1016/j.ajkd.2003.07.007
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Mange,KevinC
中科院分区：
文献类型：
--
作者：
Weng,FrancisL;Mange,KevinC
研究背景：预防性肾移植（PRT）与提高同种异体移植物和患者存活率有关，需要在开始维持性透析前进行移植适宜性的医学评估。本研究的目的是了解相关因素的评估肾移植的时间相对于开始dialys.MethodsIn一项前瞻性研究中，病人提出的肾移植评估诊所在宾夕法尼亚大学医院完成了自我管理的questionnaire.ResultsOf 290例患者包括在分析中，44.5%尚未透析。非透析依赖者在移植评估前平均就诊时间为71.0 ± 84.7个月，而接受非抢先评估的患者在透析开始前平均就诊时间为25.0 ± 42.8个月（P < 0.001）。首先从非肾脏科医生处了解移植显著增加了接受非抢先移植评估的几率（调整后的比值比[OR]，2.46; P = 0.01）。肾病专家每额外进行3个月的慢性肾脏病护理，（调整后的OR，0.96; P < 0.001），如果患者报告有配偶作为潜在供体，则显著降低（调整后OR为0.41; P = 0.03），但不包括在内。结论在透析开始前有大量的机会进行移植评估，但这并不充分利用，而且受到所提供护理时间的影响。以及潜在活体捐赠者的类型
BackgroundPreemptive renal transplantation (PRT) has been associated with improved allograft and patient survival rates and requires that the medical evaluation for suitability for transplantation occurs before the initiation of maintenance dialysis. The aim of this study was to understand the factors associated with the timing of evaluation for renal transplantation relative to the initiation of dialysis.MethodsIn a prospective study, patients who presented to the Renal Transplant Evaluation Clinic at the Hospital of the University of Pennsylvania completed a self-administered questionnaire.ResultsOf the 290 patients included in the analysis, 44.5% were not yet on dialysis. Non—dialysis-dependent persons had seen a nephrologist for a mean of 71.0 ± 84.7 months before transplant evaluation, whereas persons who presented for nonpreemptive evaluation reported first seeing a nephrologist a mean of 25.0 ± 42.8 months before dialysis initiation (P < 0.001). First learning about transplantation from somebody other than a nephrologist significantly increased the odds of undergoing nonpreemptive transplant evaluation (adjusted odds ratio [OR], 2.46; P = 0.01). The odds of nonpreemptive evaluation were decreased for every additional 3 months of chronic renal disease care by a nephrologist (adjusted OR, 0.96; P < 0.001) and significantly decreased if the patient reported having a spouse as a potential donor (adjusted OR, 0.41; P = 0.03).ConclusionThere is substantial opportunity for transplant evaluation before dialysis initiation that is not capitalized on and is affected by the duration of care provided by a nephrologist and the type of potential living donor.