CAJ | 학술논문

目的：探讨肾脏替代治疗（renal replacement therapy，RRT）开始时间对非糖尿病终末期肾病（non diabetic end stage renal disease，NDNESRD）患者临床预后的影响。方法选择首次行 RRT 的 NDNESRD 患者89例，根据开始 RRT 时估算的肾小球滤过率（estimated glomerular filtration rate，eGFR）将患者分为提前治疗组和延迟治疗组，以患者生存率为主要临床事件，以住院率以及心血管事件、血管通路并发症、透析模式转换和腹膜炎发生率为次要临床事件，随访5年。结果两组1、3、5年生存率差异无统计学意义（P ＝0．166、0．088、0．067）。两组住院率（35．7％ vs 38．3％，P ＝0．667）、心血管事件发生率（14．3％ vs 10．6％，P ＝0．089）、血管通路并发症发生率（21．2％ vs 28．1％，P ＝0．682）及腹膜炎发生率（22．2％ vs 26．7％，P ＝0．541）差异无统计学意义。结论早期开始RRT 对 NDNESRD 患者的临床预后没有明显的益处。
목적：탐토신장체대치료（renal replacement therapy，RRT）개시시간대비당뇨병종말기신병（non diabetic end stage renal disease，NDNESRD）환자림상예후적영향。방법선택수차행 RRT 적 NDNESRD 환자89례，근거개시 RRT 시고산적신소구려과솔（estimated glomerular filtration rate，eGFR）장환자분위제전치료조화연지치료조，이환자생존솔위주요림상사건，이주원솔이급심혈관사건、혈관통로병발증、투석모식전환화복막염발생솔위차요림상사건，수방5년。결과량조1、3、5년생존솔차이무통계학의의（P ＝0．166、0．088、0．067）。량조주원솔（35．7％ vs 38．3％，P ＝0．667）、심혈관사건발생솔（14．3％ vs 10．6％，P ＝0．089）、혈관통로병발증발생솔（21．2％ vs 28．1％，P ＝0．682）급복막염발생솔（22．2％ vs 26．7％，P ＝0．541）차이무통계학의의。결론조기개시RRT 대 NDNESRD 환자적림상예후몰유명현적익처。
Objective To investigate the effect of initiation time on renal replacement therapy(RRT) for clinical prognosis of patients with non diabetic end stage renal disease (NDNESRD).Methods A total of 89 NDNESRD patients who started the first dialysis were classified into early-start group or late-start group according to estimated glomerular filtration rate(eGFR).The primary outcome was patient survival,and the secondary outcomes were hospitalization,cardiovascular events,vascular access complications,change of dialysis modality, and peritonitis.The follow-up period was five years.Results The survival rate showed no significant difference in the first,the third and the fifth years between the two groups(P =0.166, 0.088,0.067 ).Hospitalization (35.7% vs 38.3%,P = 0.667 ),cardiovascular events (14.3% vs 10.6%,P = 0.089),vascular access complications (21.2% vs 28.1%,P = 0.682)and peritonitis (22.2% vs 26.7%,P =0.541)were no difference between the two groups.Conclusion There was no significant clinical benefit comparing early versus late initiation of RRT.