中国血液净化

›› 2011, Vol. 10 ›› Issue (6): 324-327.doi: 10.3969/j.issn.1671-4091.2011.06.00

• 临床研究 • 上一篇    下一篇

慢性肾衰竭患者进入血液透析的时机及趋势分析

钟小仕 覃丹平 陈文璇 刘 岩   

  1. 广州市红十字会医院 暨南大学医学院第四附属医院肾内科
  • 收稿日期:2010-12-20 修回日期:1900-01-01 出版日期:2011-06-12 发布日期:2011-06-12
  • 通讯作者: 钟小仕

The time for initiation of hemodialysis in chronic renal failure patients and its trends

HONG Xiao-shi, QIN Dan-ping, CHEN Wen-xuan, LIU Yan   

  1. Department of Nephrology, Guangzhou Red Cross Hospital, the Fourth Affiliated Hospital of Medical College of Ji-Nan University, Guangzhou 510220, China
  • Received:2010-12-20 Revised:1900-01-01 Online:2011-06-12 Published:2011-06-12

RichHTML

0

PDF

627

摘要：

目的 分析慢性肾衰竭患者进入血液透析的时机及变化趋势。 方法 回顾性研究2007年1月1日至2009年12月31日在广州市红十字会医院新进入血液透析的慢性肾衰竭的患者144例，登记收集首次透析的生化参数包括尿素氮、肌酐、血清白蛋白等数据，并计算肾小球滤过率(glomerular filtration rate,GFR)。 结果 全部慢性肾衰竭患者进入血液透析时的GFR为(6.01±0.59)ml/(min·1.73m2)，9例患者GFR＞10 ml/(min·1.73m2)，74例患者GFR为5～10 ml/(min·1.73m2)， 61例患者GFR＜5 ml/(min·1.73m2)。糖尿病患者进入血液透析治疗时的GFR明显比非糖尿病患者高，分别为(7.41±0.47)ml/(min·1.73m2)和(5.22±0.44)ml/(min·1.73m2)，差异有统计学意义(t=28.49,P＜0.05)。慢性肾衰竭患者进入血液透析时的GFR水平，随着时间的推移呈现出越来越高的趋势。 结论 本组患者开始血液透析时机通常较迟，明显低于肾脏病预后质量指南要求；特别是非糖尿病患者。糖尿病患者及非糖尿病患者对尿毒症的耐受的差异需要进一步的研究和探讨。

关键词: 慢性肾衰竭, 血液透析, 透析时机, 趋势

Abstract:

Objective To analysis the time for initiation of hemodialysis in chronic renal failure patients and its trends. Methods A retrospective study was performed in 144 patients newly treated with hemodialysis in Guangzhou Red-Cross Hospital during Jan. 1, 2007 to Dec. 31, 2009. The biochemical parameters just before the first dialysis session were retrieved, including blood urea nitrogen, serum albumin, and serum creatinine, from which glomerular filtration rate (GFR) was then calculated. Results In the 144 patients, the mean GFR at the time for initiation of hemodialysis was 6.01±0.59 ml/min·1.73m2. The initial mean GFR was ＞10ml/min·1.73m2 in 9 patients, 5 to 10ml/min·1.73m2 in 74 patients, and ＜5ml/min·1.73m2 in 61 patients. Diabetic patients had higher initial GFR than non-diabetic patients (7.41±0.47 vs. 5.22±0.44, t=28.49, P＜0.05). The trend of higher GFP at the initiation of hemodialysis became evident over time in chronic renal failure patients. Conclusion In our hemodialysis center, the initiation of hemodialysis was often delayed to the situation much lower than the requirements suggested by K/DOQI guidelines, especially in non-diabetic patients. The difference in the ability to tolerate uremia between diabetic and non-diabetic patients needs to be further investigated.

Key words: Hemodialysis, Time for initiation of dialysis, Trend