搜索到21925篇“ DIALYSIS“的相关文章
Anaesthesia in chronic dialysis patients:A narrative review
2025年
The provision of anaesthesia for individuals receiving chronic dialysis can be challenging.Sedation and anaesthesia are frequently managed by critical care clinicians in the intensive care unit or operating room.This narrative review summarizes the important principles of sedation and anaesthesia for individuals on long-term dialysis,with reference to the best available evidence.Topics covered include the pharmacology of anaesthetic agents,the impacts of patient characteristics upon the pre-anaesthetic assessment and critical illness,and the fundamentals of dialysis access procedures.
Julian Yaxley
关键词:DIALYSISSEDATIONANAESTHESIAPHARMACOLOGY
内脏脂肪面积对腹膜透析病人心肺耐力的影响
2025年
目的探讨持续非卧床腹膜透析(CAPD)病人心肺耐力与内脏脂肪面积的相关性。方法共纳入2021年5月至2022年10月于徐州医科大学附属医院进行规律CAPD的52例病人,进行心肺耐力(CRF)及内脏脂肪面积(VFA)相关指标测量,以峰值耗氧量(Peak VO2)为CRF金标准,将病人分为CRF轻度受损组(Peak VO2≥20 mL·kg^(−1)·min^(−1))及CRF中重度受损组(Peak VO2<20 mL·kg^(−1)·min^(−1))。分析两组间VFA及临床指标有无差异性,探讨CRF独立危险因素。结果CRF中重度受损组VFA、脂肪组织指数、浮肿指数(ECW/TBW)、空腹血糖及三酰甘油显著高于CRF轻度受损组,CRF中重度受损组VFA为73.95(59.83,107.03)cm2,CRF轻度受损组VFA为50.75(40.68,56.85)cm2,而转铁蛋白饱和度显著低于轻度受损组(均P<0.05)。通过Pearson与Spearman相关分析发现Peak VO2分别与脂肪组织指数、内脏脂肪面积、浮肿指数、空腹血糖、CRP、糖尿病状态、服用降脂药呈负相关(均P<0.05),与转铁蛋白饱和度(r=0.32,P=0.021)呈正相关。骨骼肌指数与Peak VO2差异无统计学意义(P>0.05)。将单因素回归分析中P<0.05的指标纳入到多元线性回归分析中,发现内脏脂肪面积(β=−0.40,P=0.002)、尿素清除指数(kt/V)(β=0.31,P=0.013)及糖尿病状态(β=−0.38,P=0.026)为CRF的独立风险因素。结论内脏脂肪面积、尿素清除指数及患有糖尿病为CAPD病人低心肺耐力独立风险因素,内脏脂肪面积对心肺耐力的影响更大,加强内脏脂肪的管理可减少CAPD病人心血管疾病。
张紫艳谭丹丹黄德剑董大宝张颖
关键词:心肺耐力心血管疾病
Application of Dorzagliatin in peritoneal dialysis patients with type 2 diabetes mellitus:A case report
2025年
BACKGROUND Treating diabetes in dialysis patients remains a challenge,with many hypoglycemic drugs requiring dose adjustments or avoidance in these patients.CASE SUMMARY This report describes an 83-year-old female patient with a 30-year history of type 2 diabetes(T2DM)who had struggled to control her blood sugar for more than a year.She had a history of high blood pressure for 30 years,had undergone continuous ambulatory peritoneal dialysis for more than two years,was 163 cm tall,weighed 77 kg,and had a body mass index of 28.98 kg/m2.Despite intensive insulin therapy at a daily dose of 150 units,adding Dorzagliatin at a dosage of 75 mg orally twice daily led to immediate blood sugar improvement and a gradual reduction in insulin dosage.After one month of follow-up,the fasting plasma glucose was 6-8 mmol/L,and the 2-hour postprandial glucose was 8-12 mmol/L.CONCLUSION To our knowledge,this report is the first to use Dorzagliatin to treat type 2 diabetes peritoneal dialysis patients with challenging glucose control.Dorzagliatin,a novel glucokinase activator primarily metabolized by the liver,exhibits no pharmacokinetic differences among patients with varying degrees of chronic kidney disease.It has a high plasma protein binding rate and may not be cleared by peritoneal dialysis,potentially offering a new glycemic control option for Type 2 diabetic patients on peritoneal dialysis.
Fang ChenBo AnWen-Cheng AnGang FuWei HuangHui-Xian Yan
预后营养指数对腹膜透析患者心血管疾病死亡的影响:一项多中心回顾性队列研究
2025年
背景心血管疾病(CVD)是腹膜透析(PD)患者死亡的主要原因,而营养不良是PD患者发生CVD及死亡的重要危险因素之一。预后营养指数(PNI)作为一种综合评估患者免疫、炎症和营养状态的指标,因其具有便利性与可靠性等优点,在肿瘤等多种疾病的预后评估中得到了广泛应用。然而,不同时间点的营养状态与PD患者预后之间的关系仍有待进一步探究。目的探讨PD患者首年PNI与CVD死亡之间的关系。方法本研究为多中心、回顾性观察性队列研究,纳入2000-01-01—2019-07-01在南方医科大学南方医院、南方医科大学顺德医院、佛山市第一人民医院以及赣州市人民医院4所中心置管并开始接受PD治疗的1640例PD患者作为研究对象。对患者进行随访,随访截止时间为2021-07-01,终点事件为CVD死亡并记录患者生存时间及具体死亡原因。应用限制性立方条图(RCS)分析PNI与PD患者CVD死亡风险之间的非线性关联;采用Kaplan-Meier法绘制PD患者的生存曲线,绘制PNI预测PD患者CVD死亡的受试者工作特征(ROC)曲线,并根据最佳截断值(cut-off=40.46)将患者分为低PNI组703例与高PNI组937例;采用Log-rank检验和Cox风险回归模型分析探讨PNI对PD患者CVD死亡的影响。结果本研究中位随访时间为30个月,随访期间共148例患者死亡,其中CVD死亡73例(49.32%)。RCS结果表明,PNI与CVD死亡事件呈线性关联(P for Nonlinear=0.655)。ROC曲线显示,PNI预测PD患者CVD死亡的曲线下面积(AUC)为0.717(95%CI=0.659~0.775,P<0.001),灵敏度为74.0%,特异度为58.6%。Kaplan-Meier生存分析结果显示,低PNI组CVD生存率低于高PNI组(χ^(2)=26.685,P<0.001)。多因素Cox风险回归模型分析,校正性别、年龄及CVD病史等混杂因素后,低PNI组仍是CVD死亡的独立预测因素(HR=7.76,95%CI=1.72~35.06,P=0.008),亚组分析结果仍稳健,无明显交互作用。结论PNI降低是PD患者CVD死亡的独立影响因素,PD首年PNI评分在评估PD�
朱露艾军廖生武黄淑婷龚妮容孔耀中刘德慧窦献蕊张广清
关键词:腹膜透析预后营养指数预后队列研究
Return to Dialysis after Kidney Graft Failure
2024年
Introduction: The transition period from renal transplantation to dialysis is associated with high morbidity and mortality. The aim of this study is to describe the clinical and paraclinical characteristics, therapeutic management and evolutionary profile of patients returning to dialysis after kidney graft failure. Material and Methods: This was a retrospective, descriptive study conducted in the Nephrology-Dialysis-Renal Transplant Department at university hospital IbnSina between January 1998 and December 2021. We included all renal transplant recipients who had experienced kidney graft dysfunction and returned to dialysis. Patients with a follow-up after return to dialysis of less than 1 year were excluded. Results: Among 166 renal transplant recipients, 20 returned to dialysis after a median renal graft life of 85.5 months [42 - 186], corresponding to a prevalence of 12%. The mean age of our patients was 38.7 ± 11.9 years, with a M/F sex ratio of 2.3. Dialysis was initiated urgently in 10 patients (50%). Hemodialysis was the most commonly used modality (75%). Central venous catheterization was used in 35% of cases, including tunneled catheters. General condition is impaired in all patients, with persistent hypertension in 70% of cases. Mean uremia was 2.35 ± 0.8 g/l, mean creatinine 116 ± 48.3 mg/l, giving a mean GFR of 5.1 ± 2.2 ml/min. Mean albuminemia was 32.9 ± 6 g/l and mean hemoglobinemia 8.6 ± 1.9 g/dl. During the first year of follow-up, none of the patients died. However, 13 patients required hospitalization, with a mean length of stay of 15 days. Eight patients were hospitalized for infections and 5 for renal graft intolerance syndrome. After a mean follow-up of 22 months, 6 patients were detransplanted following graft necrosis. Conclusion: Return to dialysis after RT is fraught with a high rate of complications. The management of these patients must be optimized to improve their vital prognosis and quality of life.
Ikram FtaimiSoukaina SakabManal ChattahiTarik BouattarLoubna BenamarRabia BayahiaNaima Ouzeddoun
关键词:DIALYSISIMMUNOSUPPRESSION
透析患者应用自动化腹膜透析的研究进展
2024年
腹膜透析(PD)患者数量正逐年攀升,截至2021年底我国已超过12万例。自动化腹膜透析(APD)技术能实现对透析液的自动和连续的控制,并能实现多种模式的腹膜透析器自动操作,在患者夜间入睡时进行居家治疗,患者可以在白天进行正常的活动,让广大PD患者受益。在欧美等发达地区高达60%的透析患者选择APD,而在我国,APD使用占比不到1%。本文将从APD对PD患者常见并发症和病死率的影响、APD的经济学成本及APD的远程监控功能4个方面对APD技术的研究进展进行阐述,以期让大众对APD技术深入理解,能根据自身需求科学合理地选择PD方式,提高生活质量。
梁高旗李爱仙
关键词:腹膜透析腹膜炎远程监控
Peritoneo-Vaginal Leaks in Peritoneal Dialysis: A Report of 3 Cases
2024年
Introduction: Peritoneal dialysis (PD) is an extra-renal purification technique indicated for patients with end-stage kidney disease (ESKD). Although it has many advantages, it also has a number of complications, such as peritoneo-vaginal leakage of dialysate. Cases Reports: Three male patients, aged 70, 50 and 77 respectively, with ESKD were placed on PD. All three patients presented with inadequate drainage and the progressive appearance of bilateral hydrocele, which occurred one year (late leakage), two and four days (early leakage) respectively after the initiation of exchanges. The etiological investigation led to the conclusion of a peritoneo-vaginal leak associated with an inguinal hernia in only one case. The two cases of early leakage were treated by temporary suspension of PD, with a good response in one case and failure in the second, leading to hisdefinitive transfer to hemodialysis (HD);however, the hernia repair enabled immediate resumption of PD in the third patient. Discussion and Conclusion: Peritoneo-vaginal leakage is a rare mechanical complication in PD. The clinical examination plays an essential role in confirming the diagnosis and in the therapeutic decision. If the diagnosis is uncertain, or if there is a clinical need to show the anatomy of the leak, an imaging approach becomes desirable. This complication should not prevent the progression of PD in the management of patients with ESKD.
Mariam JdidouSara ElmakkoulNabil HmaidouchNaima OuzeddounLoubna Benamar
维持性腹膜透析患者透析龄的预后因素分析
2024年
目的分析维持性腹膜透析患者透析龄的预后相关因素。方法回顾性分析常青藤肾脏病联盟(evergreen tree nephrology association,ETNA)腹膜透析数据库2005年11月─2020年5月诊治的571例成人维持性腹膜透析患者临床资料,计算生存率、技术生存率,分析影响患者预后因素。腹膜透析(peritoneal dialysis,PD)患者根据透析龄分为长透析龄组(≥60月),短透析龄组(<60月),分析2组患者预后及影响透析龄的危险因素。结果571例PD患者1、2、3、5、10年累积生存率为94%、88.8%、80.9%、70.3%、49.8%,累积技术生存率分别为94%、88.8%、80.8%、69.3%、39.2%。多因素COX回归分析显示:慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)病史(HR=3.339,95%CI:1.054~10.576,P=0.040)、低密度脂蛋白升高(HR=1.222,95%CI:1.032~1.447,P=0.020)、肺部感染(HR=1.568,95%CI:1.252~1.965,P<0.001)是PD患者死亡的独立危险因素。Logistic回归分析显示:吸烟(OR=0.349,95%CI:0.139~0.873,P=0.024)、全段甲状旁腺激素(iPTH)升高(OR=0.999,95%CI:0.998~1.000,P=0.048)、尿量少(OR=1.001,95%CI:1.000~1.001,P<0.001)是影响透析龄的独立危险因素。结论吸烟、iPTH升高、尿量少是影响透析龄的独立危险因素,戒烟、合理降低iPTH、保护残余肾功能可延长患者透析时间。
梁如练温跃强汪年松汪年松
关键词:腹膜透析
Selection of dialysis methods for end-stage kidney disease patients with diabetes被引量:1
2024年
The increasing prevalence of diabetes has led to a growing population of endstage kidney disease(ESKD)patients with diabetes.Currently,kidney transplantation is the best treatment option for ESKD patients;however,it is limited by the lack of donors.Therefore,dialysis has become the standard treatment for ESKD patients.However,the optimal dialysis method for diabetic ESKD patients remains controversial.ESKD patients with diabetes often present with complex conditions and numerous complications.Furthermore,these patients face a high risk of infection and technical failure,are more susceptible to malnutrition,have difficulty establishing vascular access,and experience more frequent blood sugar fluctuations than the general population.Therefore,this article reviews nine critical aspects:Survival rate,glucose metabolism disorder,infectious complications,cardiovascular events,residual renal function,quality of life,economic benefits,malnutrition,and volume load.This study aims to assist clinicians in selecting individualized treatment methods by comparing the advantages and disadvantages of hemodialysis and peritoneal dialysis,thereby improving patients’quality of life and survival rates.
Yao-Hua HuYa-Li LiuLing-Fei MengYi-Xian ZhangWen-Peng Cui
关键词:DIABETESHEMODIALYSIS
Secondary Hyperparathyroidism in Dialysis Patients: Short- and Long-Term Outcomes of Conservative Parathyroidectomy
2024年
Secondary hyperparathyroidism (HPT) is frequent in dialysis patients. Parathyroidectomy (PTX) is indicated for patients who failed medical therapy. We reviewed the data from 184 dialysis patients who underwent PTX between January 2015 and January 2023. We aimed to evaluate the short and long term outcomes of PTX in dialysis patients, comparing the conservative 3/4 versus 7/8 techniques in this population.166 dialysis patients with secondary HPT were included. A conservative subtotal PTX (sPTX) 7/8 was performed in 72% of patients and sPTX 3/4 in 28% of them. Severe postoperative hypocalcaemiaocurred in 45 patients (27%). Hypocalcaemia was significantly more frequent in the sPTX 7/8 group (p = 0.012). One case of persistent HPT (0.6%) and 20 cases of recurrence (12%) were diagnosed. Recurrence was more frequent in the sPTX 3/4 group (15%). No deaths were reported during the perioperative period.
Imane SaidiSara ElmaakoulNaima OuzeddounLoubna Benamar
关键词:DIALYSIS

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