Risk of peritonitis and technique failure by CAPD connection technique: a national study.
Risk of peritonitis and technique failure by CAPD connection technique: a national study.
复制标题
CAPD 连接技术的腹膜炎风险和技术失败：一项国家研究。
DOI：
10.1038/ki.1992.375
复制
发表时间：
1992
影响因子：
19.6
通讯作者：
Wolfe,RA
中科院分区：
文献类型：
--
作者：
Port,FK;Held,PJ;Nolph,KD;Turenne,MN;Wolfe,RA
CAPD连接技术导致腹膜炎和技术失败的风险：一项全国性研究腹膜炎是持续性非卧床腹膜透析（CAPD）长期治疗的主要并发症。本研究旨在根据初始CAPD连接技术评价腹膜炎和技术失败的风险。对1989年1月1日至6月30日期间在家中开始CAPD治疗的所有美国机构的患者进行了长达21个月的初始CAPD连接技术随访，以改变技术或透析方式，移植，死亡或失访。患者分为标准连接技术（SCT）（N = 1，133）、Y型管（N = 1，067）、标准UV管（N = 916）和O型管（N = 167）。对至首次腹膜炎发作的时间进行了精算分析，并使用考克斯比例风险模型，该模型调整了年龄、性别、人种、ESRD原因、CAPD计划规模和CAPD前的ESRD治疗。SCT的平均腹膜炎发生间隔为9.0个月，Y型管为15.0个月，标准UV为13.4个月，O型管为9.4个月。与SCT相比，Y型管首次腹膜炎的相对风险（考克斯分析RR）为0.60（低40%）（P < 0.01），标准UV为0.75（P < 0.01），O型管（NS）与SCT相似（RR = 0.96），其他均相同。至第二次腹膜炎发作的分析时间（N = 1，271）与至CAPD技术失败的时间分析结果相似。在年轻和黑人患者中观察到腹膜炎和技术失败的RR显著更高。这些结果表明，连接技术的使用具有优越的上级结果。
Risk of peritonitis and technique failure by CAPD connection technique: A national study. Peritonitis has been a leading complication of long-term therapy with continuous ambulatory peritoneal dialysis (CAPD). This study was designed to evaluate the risk of peritonitis and technique failure according to the initial CAPD connection technique. Patients from all U.S. facilities starting CAPD therapy at home between January 1 and June 30, 1989 were followed for up to 21 months on the initial CAPD connection technique to change in technique or dialytic modality, to transplantation, death or loss to follow-up. Patients were grouped into standard connection techniques (SCT) (N = 1,133), Y-set (N = 1,067), standard UV set (N = 916) and O-set (N = 167). The time to first peritonitis episode was analyzed actuarially and by using the Cox proportional hazards model which adjusted for age, sex, race, cause of ESRD, CAPD program size and ESRD therapy prior to CAPD. Peritonitis occurred on average at 9.0 month intervals with SCT, 15.0 months with Y-set, 13.4 with standard UV and 9.4 with O-set. The relative risk (RR by Cox analysis) of first peritonitis compared to SCT was 0.60 (40% lower) for the Y-set (P < 0.01), 0.75 for standard UV (P < 0.01), and similar to SCT (RR = 0.96) for the O-set (NS), all else being equal. Analysis time to second (N = 1,271) peritonitis episode gave similar results as did analysis of time to CAPD technique failure. Significantly higher RR of peritonitis and technique failure was observed for younger and black patients. These findings suggest the utilization of connection techniques with superior results.