每周两次血液透析治疗的终末期肾病患者的透析剂量与死亡风险因素：一项前瞻性队列研究。

Dialysis dose and risk factors for death among ESRD patients treated with twice-weekly hemodialysis: a prospective cohort study.

作者信息

Panaput Thanachai, Thinkhamrop Bandit, Domrongkitchaiporn Somnuek, Sirivongs Dhavee, Praderm Laksamon, Anukulanantachai Jirasak, Kanokkantapong Chavasak, Tungkasereerak Pakorn, Pongskul Cholatip, Anutrakulchai Sirirat, Keobounma Thathsalang, Narenpitak Surapong, Intarawongchot Pisith, Suwattanasin Ammrit, Tatiyanupanwong Sajja, Niwattayakul Kannika

机构信息

Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.

出版信息

Blood Purif. 2014;38(3-4):253-62. doi: 10.1159/000368885. Epub 2015 Jan 6.

DOI:10.1159/000368885

PMID:25573488

Abstract

BACKGROUND/AIMS: We aimed to define the dosing and risk factors for death in patients undergoing twice-weekly hemodialysis.

METHODS

A prospective multi-center cohort study was conducted with one-year observation. Patients treated with twice- or thrice-weekly hemodialysis were identified. Death and first admission were the outcomes. spKt/V was a factor of interest.

RESULTS

We enrolled 504 twice-weekly and 169 thrice-weekly hemodialysis patients. The mean weekly values of spKt/V in the two groups were 3.4 and 5.1. The one-year survival rate and times to hospitalization were similar in both groups. The hazard ratios for death in higher spKt/V quartile was not associated with lower mortality, p = 0.70. The four significant predictors for death were serum albumin, HR = 2.6, current smoking, HR = 19.3, age, HR = 1.1, and the Index of Coexistent Disease [ICED], HR = 1.9.

CONCLUSION

The effect of spKt/V on short-term mortality was not obvious in twice-weekly dialysis patients. Attention should be paid to patients who smoke, have hypoalbuminemia, are elderly, or have a high ICED.

摘要

背景/目的：我们旨在确定接受每周两次血液透析患者的给药剂量及死亡风险因素。

方法

进行了一项为期一年观察的前瞻性多中心队列研究。确定接受每周两次或三次血液透析治疗的患者。观察终点为死亡和首次住院。标准化Kt/V（spKt/V）是感兴趣的因素。

结果

我们纳入了504例每周两次血液透析患者和169例每周三次血液透析患者。两组的spKt/V每周均值分别为3.4和5.1。两组的一年生存率和住院时间相似。spKt/V四分位数较高组的死亡风险比与较低死亡率无关，p = 0.70。四个显著的死亡预测因素为血清白蛋白，风险比（HR）= 2.6；当前吸烟，HR = 19.3；年龄，HR = 1.1；以及共存疾病指数[ICED]，HR = 1.9。