双腔在线血液透析滤过与高通量血液透析对老年终末期肾病患者的效果比较  

Comparison of the effect of on-line paired hemodiafiltration and high-flux hemodialysis in the treatment of elderly patients with end-stage renal disease effectiveness and safety of mainte‐nance hemodialysis patients

作　　者：谭娉婵 邓卫[1] 余宗超[2] 区景运[1] TAN Ping-chan;DENG Wei;YU Zong-chao;OU Jing-yun(Department of Internal Medicine,Kaiping Central Hospital,Jiangmen 529300,China;Department of Nephrology,the First Affiliated Hospital of Jinan University,Guangzhou 510000,China)

机构地区：[1]广东省开平市中心医院内一科,广东江门529300 [2]暨南大学附属第一医院肾内科,广东广州510000

出　　处：《广东医科大学学报》2021年第5期625-628,共4页Journal of Guangdong Medical University

摘　　要：目的比较双腔在线血液透析滤过(PHF)与高通量血液透析(HFHD)对老年终末期肾病(ESKD)患者的效果。方法收集381例ESKD患者,按治疗方法分为PHF组(n=190)和高通量血液透析(HFHD)组(n=191)。记录患者透析相关的不良事件、全因住院和死亡情况。结果与HFHD组相比,PHF组发生至少1次不良事件、无症状性低血压、肌肉痉挛较少,心律失常发生较多(P<0.01或0.05)。PHF组全因住院309次,HFHD组346次,其中PHF组患者因血管通路功能障碍入院的比例明显低于HFHD组(11.7%vs 19.4%,P<0.01)。Kaplan-Meier生存分析结果显示,两组全因死亡率差异无统计学意义(P>0.05)。结论与HFHD比较,PHF透析耐受性好,因血管通路功能障碍入院的比例低,更适合老年ESKD患者。Objective To compare the effect of on-line paired hemodiafiltration(PHF)and high-flux hemodialysis(HFHD)in the treatment of elderly patients with end-stage renal disease(ESKD).Methods A total of 381 ESKD patients were selected for the study and divided into the PHF Group(n=190)and HFHD Group(n=191)according to the therapies.Adverse events related to dialysis,all-cause hospitalization and death were recorded during the entire dialysis period.Results Compared with the HFHD Group,the PHF group had at least 1 adverse event,asymptomatic hypotension,less muscle spasm,and more cases of arrhythmias(P<0.01 or 0.05).There were 309 all-cause hospitalizations in the PHF Group and 346 all-cause hospitalizations in the HFHD Group,and the PHF Group had the proportion of admissions due to vascular access dysfunction significantly lower than that of the HFHD Group(11.7%vs 19.4%,P<0.01).Kaplan Meier survival analysis showed that there was no statistical difference in all-cause mortality between the HFHD Group and PHF Group(P>0.05).Conclusion PHF has better tolerance and lower proportion of admissions due to vascular access dysfunction compared with the HFHD.It is more suitable for the elderly ESKD patients.

关 键 词：双腔在线血液透析滤过 透析耐受性 老年 终末期肾病 

分 类 号：R692[医药卫生—泌尿科学]