Persistent low albumin and temporary vascular access in pediatric patients with SLE on hemodialysis.
Persistent low albumin and temporary vascular access in pediatric patients with SLE on hemodialysis.
复制标题
接受血液透析的 SLE 儿科患者持续低白蛋白和临时血管通路。
DOI：
10.1007/s00467-009-1227-5
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Furth,SusanL
中科院分区：
文献类型：
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作者：
Sule,SangeetaD;Fadrowski,JeffreyJ;Fivush,BarbaraA;Neu,AliciaM;Furth,SusanL
患有系统性红斑狼疮 (SLE) 的儿科患者通常会出现严重的肾脏疾病。在之前的横断面分析中，我们表明，与其他原因继发的 HD 儿科患者相比，继发 SLE 的 ESRD 儿科患者血清白蛋白水平较低，且用于血液透析 (HD) 的永久性血管通路较少。这项纵向研究的目的是确定这些目标是否随着时间的推移而有所改善。为此，我们对 ESRD 临床表现测量项目 2000-2004 研究年中接受 HD 的患者进行了纵向分析，比较了 SLE 儿科患者和其他原因导致 ESRD 的儿科患者的临床目标实现情况。在纵向随访中，与其他维持 HD 的 ESRD 儿童相比，SLE 儿科患者达到目标白蛋白水平的可能性较小 [比值比 (OR) 0.18，95% 置信区间 (CI) 0.09, 0.35]，并且比其他儿科患者更不可能发生动静脉瘘或移植物 (OR 0.45，95% CI 0.23，0.89)。维持 HD 治疗的 SLE 儿科患者因无法达到某些与改善其他人群长期预后相关的临床目标而面临特别高的风险。即使他们长期接受透析，情况也是如此。
Pediatric patients with systemic lupus erythematosus (SLE) often present with significant kidney disease. In a previous cross-sectional analysis, we showed that pediatric patients with ESRD secondary to SLE have lower serum albumin levels and less permanent vascular access for hemodialysis (HD) compared to pediatric patients on HD secondary to other causes. The goal of this longitudinal study was to determine if there was an improvement in these targets over time. To this end, we performed a longitudinal analysis of patients receiving HD in the ESRD Clinical Performance Measures Project 2000–2004 study years, comparing achievement of clinical targets between pediatric patients with SLE and pediatric patients with other causes of ESRD. In the longitudinal follow-up, pediatric patients with SLE were less likely to reach target albumin levels than other children with ESRD maintained on HD [odds ratio (OR) 0.18, 95% confidence interval (CI) 0.09, 0.35] and were less likely to have arteriovenous fistulas or grafts than other pediatric patients (OR 0.45, 95% CI 0.23, 0.89). Pediatric patients with SLE maintained on HD are at particularly high risk for failing to meet some clinical targets that have been associated with improved long-term outcomes in other populations. This is true even as they remain on dialysis over time.