Early start of dialysis has no survival benefit in end-stage renal disease patients.
Early start of dialysis has no survival benefit in end-stage renal disease patients.
复制标题
DOI：
10.3346/jkms.2012.27.10.1177
复制
发表时间：
2012-10
影响因子：
4.5
通讯作者：
Kim S
中科院分区：
文献类型：
--
作者：
Chang JH;Rim MY;Sung J;Ko KP;Kim DK;Jung JY;Lee HH;Chung W;Kim S
开始透析的时间仍然存在争议。这项研究的目的是使用倾向记分法比较早开始和晚开始的透析患者的死亡率。研究对象为2000年1月至2009年6月因终末期肾病(ESRD)而开始透析的836例成人患者。根据透析的开始时间，患者被分成早开始组或晚开始组。在基于倾向得分的配对后，450名患者留下来。在透析开始时，早开始组的平均估计肾小球滤过率(EGFR)为11.1mL/min/1.73m2，而晚开始组为6.1mL/min/1.73m2。早起组和晚起组患者的生存率差异无统计学意义(对数等级检验，P=0.172)。对于年龄为70岁的≥患者和/或白蛋白水平为3.5g/dL的患者，早开始组的总死亡风险高于晚开始组(危险比：3.29；P=0.048)(危险比：2.53；P=0.046)。早发组和晚发组的终末期肾病患者的存活率相当。开始透析的时间应该根据临床结果和EGFR来确定。
The timing for dialysis initiationis still debated. The aim of this study was to compare mortality rates, using a propensity-score approach, in dialysis patients with early or late starts. From January 2000 to June 2009, incident adult patients (n = 836) starting dialysis for end-stage renal disease (ESRD) were enrolled. The patients were assigned to either an early- or late-start group depending on the initiation time of the dialysis. After propensity-score-basedmatching, 450 patients remained. At the initiation of dialysis, the mean estimated glomerular filtration rate (eGFR) was 11.1 mL/min/1.73 m2 in the early-start group compared with 6.1 mL/min/1.73 m2 in the late-start group. There were no significant differences in survival between the patients in the early- and late-start groups (Log rank tests P = 0.172). A higher overall mortality risk was observed in the early-start group than in the late-start group for the patients aged ≥ 70 yr (hazard ratio [HR]: 3.29; P = 0.048) and/or who had albumin levels ≥ 3.5 g/dL (HR: 2.53; P = 0.046). The survival of the ESRD patients was comparable between the patients in the early and late-start groups. The time to initiate dialysis should be determined based on clinical findings as well as the eGFR.
登录
查看更多内容
影响因子：
--
作者：
O'Hare AM;Choi AI;Boscardin WJ;Clinton WL;Zawadzki I;Hebert PL;Kurella Tamura M;Taylor L;Larson EB
通讯作者：
Larson EB
影响因子：
6.1
作者：
Yang, Wu-Chang;Hwang, Shang-Jyh
通讯作者：
Hwang, Shang-Jyh
影响因子：
4.2
作者：
TATTERSALL, J;GREENWOOD, R;FARRINGTON, K
通讯作者：
FARRINGTON, K
影响因子：
19.6
作者：
Lassalle, Mathilde;Labeeuw, Michel;Stengel, Benedicte
通讯作者：
Stengel, Benedicte
影响因子：
158.5
作者：
Cooper, Bruce A.;Branley, Pauline;Pollock, Carol A.
通讯作者：
Pollock, Carol A.