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PLOS ONE:如何预测无尿腹膜透析患者生存率

2018-04-27 海北 MedSci原创

常见的无尿腹膜透析(PD)患者通常比残余尿量的PD患者具有更高的死亡率。最近,来自韩国的研究人员进行了一项研究,旨在评估无尿PD患者的生存预测因素。

常见的无尿腹膜透析(PD)患者通常比残余尿量的PD患者具有更高的死亡率。最近,来自韩国的研究人员进行了一项研究,旨在评估无尿PD患者的生存预测因素。
研究人员分析了韩国全国前瞻性队列研究中的无尿PD患者(n = 505,每日尿液<100 mL),并通过倾向评分匹配以2比1的比率比较存活和未存活的无尿PD患者。倾向方法用于调整患者年龄,透析持续时间,和糖尿病的存在。
在总的无尿PD患者中,未存活患者年龄显着较大,糖尿病,冠状动脉疾病和心律失常发生率较高,血清肌酐和白蛋白水平较低。
在倾向评分匹配后,多变量Cox回归分析显示,随着血清白蛋白增加(HR = 0.347,p = 0.0094),患者死亡风险降低。使用接受者-操作特征曲线(ROC)分析显示,在未匹配的总PD患者中,使用3.6g / dL的血清白蛋白截断值可以预测存活率,灵敏度为59.4%,特异性为63.2%。
高白蛋白水平对于高龄患者(≥50岁),无糖尿病,低超滤量(<1000 mL /天),低血清肌酐水平(<10 mg/ dL),低总胆固醇(<177.5 mg / dL),低铁蛋白(<100 ng / mL),低高敏C反应蛋白(hs-CRP)(<0.1 mg / dL)的患者的有益影响显着更大。
因此,该研究显示,无尿PD患者的生存与年龄,合并症,以及肌酸酐和白蛋白等营养因素有关。通过倾向评分匹配调整后,血清白蛋白水平是无尿PD患者存活的独立预测因子。

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  6. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Apr 27 09:16:31 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309747, encodeId=6a75309e47ad, content=学习了.获益匪浅.感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/02/27/c53a212859edcad4f60a54feffff50bb.jpg, createdBy=67cf1525321, createdName=13718711b3m, createdTime=Fri Apr 27 08:39:08 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309740, encodeId=9e6a309e4006, content=学习谢谢分享, beContent=null, objectType=article, channel=null, 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    2018-04-28 xuyong530
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level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri Apr 27 08:28:36 CST 2018, time=2018-04-27, status=1, ipAttribution=)]
    2018-04-27 1821f909bem

    学习了

    0

  8. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Apr 27 09:16:31 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309747, encodeId=6a75309e47ad, content=学习了.获益匪浅.感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/02/27/c53a212859edcad4f60a54feffff50bb.jpg, createdBy=67cf1525321, createdName=13718711b3m, createdTime=Fri Apr 27 08:39:08 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309740, encodeId=9e6a309e4006, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri Apr 27 08:28:36 CST 2018, time=2018-04-27, status=1, ipAttribution=)]
    2018-04-27 哈哈869

    学了

    0

  9. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Apr 27 09:16:31 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309747, encodeId=6a75309e47ad, content=学习了.获益匪浅.感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/02/27/c53a212859edcad4f60a54feffff50bb.jpg, createdBy=67cf1525321, createdName=13718711b3m, createdTime=Fri Apr 27 08:39:08 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309740, encodeId=9e6a309e4006, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri Apr 27 08:28:36 CST 2018, time=2018-04-27, status=1, ipAttribution=)]
    2018-04-27 13718711b3m

    学习了.获益匪浅.感谢分享

    0

  10. 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level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri Apr 27 08:28:36 CST 2018, time=2018-04-27, status=1, ipAttribution=)]
    2018-04-27 龙胆草

    学习谢谢分享

    0

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由此可见,该研究的结果表明低血清维生素D水平与接受透析的儿童和青少年焦虑之间存在独立的相关性,需要在今后的实验和临床研究中进一步加以证实。

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