Discontinuation of dialysis therapy as a cause of death.
Discontinuation of dialysis therapy as a cause of death.
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停止透析治疗是死亡原因。
DOI：
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发表时间：
1989
影响因子：
4.2
通讯作者：
W. Ferguson
中科院分区：
文献类型：
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作者：
F. Port;R. Wolfe;V. Hawthorne;W. Ferguson
1980-1985年期间，密歇根州5，208例终末期肾病（ESRD）患者中，282例因停止维持生命的透析治疗而死亡，随访至1986年。根据治疗开始后60个月的生命表估计，9.4%的患者因透析终止而死亡，其中女性为11%，男性为8%（p = 0.02），年龄小于或等于49岁为0.1-3.4%，大于80岁为56%，白色患者为12%，黑人患者为4%（p <0.001），糖尿病ESRD患者为16%（高于任何其他组，p <0.05）。考克斯回归模型证实了种族、糖尿病和年龄的这些重要发现，并显示1980-1985年的总体退出率显着增加了60%（1.10/年，p小于0.02）。对1980-1984年期间透析死亡率中2,564例透析死亡的百分比进行的单独分析显示，总比率为8.9%，年龄小于或等于64岁与大于或等于65岁之间存在显著差异（p <0.001），种族（p <0.001），但不包括既往移植失败或持续非卧床腹膜透析治疗。尽管年龄和糖尿病的结果是预期的，但密歇根州肾脏登记处提供的信息无法解释透析退出随时间推移的显著增加和种族差异，并表明需要进一步研究进行探索。
Discontinuation of life-sustaining dialysis therapy led to death in 282 of 5,208 patients who started therapy for end-stage renal disease (ESRD) in Michigan during 1980-1985 with a follow-up through 1986. Based on life table estimates at 60 months after initiation of therapy, 9.4% of patients overall died due to termination of dialysis, 11% of females versus 8% of males (p = 0.02), 0.1-3.4% for ages less than or equal to 49 years versus 56% for greater than 80 years, 12% for white versus 4% for black patients (p less than 0.001) and 16% for diabetic ESRD patients (higher than any other group, p less than 0.05). The Cox regression model confirms these significant findings for race, diabetes and age, and reveals a significant 60% increase in overall withdrawals for the years 1980-1985 (1.10/year, p less than 0.02). A separate analysis of discontinuation of dialysis as the percentage of all 2,564 dialysis deaths in prevalence cases for 1980-1984 revealed an overall ratio of 8.9% with a significant difference for ages less than or equal to 64 versus greater than or equal to 65 (p less than 0.001), race (p less than 0.001) but not for prior transplant failure or continuous ambulatory peritoneal dialysis therapy. Whereas the results for age and diabetes were expected, the significant increase of dialysis withdrawal over time and the racial difference are unexplained by information available at the Michigan Kidney Registry and indicate the need for exploration by further studies.