Mortality, hospitalization and transfer to haemodialysis and hybrid therapy, in Japanese peritoneal dialysis patients
Mortality, hospitalization and transfer to haemodialysis and hybrid therapy, in Japanese peritoneal dialysis patients
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日本腹膜透析患者的死亡率、住院率以及转为血液透析和混合疗法的情况
DOI：
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发表时间：
2021
影响因子：
2.8
通讯作者：
J. Minakuchi
中科院分区：
文献类型：
--
作者：
H. Kawanishi;M. Marshall;Junhui Zhao;K. McCullough;B. Robinson;R. Pisoni;J. Perl;T. Tomo;J. Minakuchi
背景和目标：日本腹膜透析（PD）患者的生存率很高，但关于病因特异性死亡率、转为血液透析（HD）或混合透析和住院风险的报告很少。我们的目的是在日本腹膜透析和结局实践模式研究中确定转为HD、混合透析和住院的原因。方法：这项观察性研究纳入了2014-2017年日本31家机构的808例成人PD患者。前瞻性收集全因和病因特异性死亡率、住院和永久转为HD和PD/HD混合治疗的信息，并计算发生率。结果：中位随访时间为1.66年，其中162例患者转为HD，79例转为混合透析，74例患者死亡。全因和心血管疾病（CVD）相关死亡率分别为5.1和1.7例死亡/100患者年。转移至HD和混合治疗的发生率分别为11.2和5.5次转移/100患者-年。在HD转移中，40%是由于感染（包括腹膜炎），而20%是由于溶质/水清除不足。81%的混合透析转移是由于溶质/水清除不足。全因、腹膜炎相关和CVD相关住院率分别为120.4、21.1和15.6/100患者-年。平均住院时间为19天。结论：与许多其他混合转移国家相比，日本的死亡率、住院率和转移至HD/混合透析率相对较低，占PD透析转移的三分之一。需要进一步研究来解释住院率的高机构间差异以及如何进一步降低日本PD患者的住院率。
Background and objectives: Survival of peritoneal dialysis (PD) patients in Japan is high, but few reports exist on cause-specific mortality, transfer to haemodialysis (HD) or hybrid dialysis and hospitalisation risks. We aimed to identify reasons for transfer to HD, hybrid dialysis and hospitalisation in the Japan Peritoneal Dialysis and Outcomes Practice Patterns Study. Methods: This observational study included 808 adult PD patients across 31 facilities in Japan in 2014–2017. Information on all-cause and cause-specific mortality and hospitalisation and permanent transfer to HD and PD/HD hybrid therapy were prospectively collected and rates calculated. Results: Median follow-up time was 1.66 years where 162 patients transferred to HD, 79 transferred to hybrid dialysis and 74 patients died. All-cause and cardiovascular disease (CVD)-related mortality rates were 5.1 and 1.7 deaths/100 patient-years, respectively. Rates of transfer to HD and hybrid therapy were 11.2 and 5.5 transfers/100 patient-years, respectively. Among HD transfers, 40% were due to infection (including peritonitis), while 20% were due to inadequate solute/water clearance. Eighty-one percent of hybrid dialysis transfers were due to inadequate solute/water clearance. All--cause, peritonitis-related and CVD-related hospitalisation rates were 120.4, 21.1 and 15.6/100 patient-years, respectively. Median hospital length of stay was 19 days. Conclusions: Mortality, hospitalisation and transfer to HD/hybrid dialysis rates are relatively low in Japan compared to many other countries with hybrid transfers, accounting for one-third of dialysis transfers from PD. Further study is needed to explain the high inter-facility variation in hospitalisation rates and how to further reduce hospitalisation rates for Japanese PD patients.
医疗保险扩展透析预期支付系统下腹膜透析患者的结果。
DOI：
10.2215/cjn.01610219
发表时间：
2019
期刊：
Clinical journal of the American Society of Nephrology : CJASN
影响因子：
--
作者：
Young,EricW;Kapke,Alissa;Ding,Zhechen;Baker,Regina;Pearson,Jeffrey;Cogan,Chad;Mukhopadhyay,Purna;Turenne,MarcN
通讯作者：
Turenne,MarcN
影响因子：
13.2
作者：
Perl, Jeffrey;Fuller, Douglas S.;Johnson, David W.
通讯作者：
Johnson, David W.