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1、腹膜透析在老年CRF中的应用复旦大学附属华东医院肾内科老年ESRD的流行病学随人口老龄化，老年CRF的诊治问题日益突出1995ERA-EDTA登记ESRD进入透析平均年龄56.8岁，其中大于60岁占52％2000年USRD资料：透析大于65岁占50％©2006bytheNationalKidneyFoundation,Inc.InternationalregistriesreportedagrowingnumberofelderlypatientswithESRD.IntheUnitedStates,in2002,incidencerates
2、ofpatientsbeginningdialysistreatmentwere1,440permillionpopulationintheagegroup65to74yearsand1,671permillionpopulationintheagegroup75yearsandolder,correspondingtoincreasesof41%and93%comparedwiththoseratesin1992,respectively.PD适合老年ESRD吗？病例男，98岁，ESRD，心衰，重度贫血。入院后HD治疗，较快好转，改为PD1
3、个月后患者被送至急诊。PE：BP130/90，HR80bpm,淡漠，端坐呼吸，全身水肿，双肺湿罗音，紧急HD，病情渐好转急诊留观期间因肺部感染而死亡腹膜透析适合老年ESRD吗？－国内的有限资料PD是老年ESRD的主要替代方式老年透析患者占所有透析者的40%与HD比较，PD治疗的老年患者在死亡率、存活率、住院率和继发感染等方面并无明显差异QUALITYOFLIFEANDCLINICALOUTCOMESINELDERLYPATIENTSPDVSHD♦Objective:Tocompareclinicaloutcomesandqualityofli
4、fe(QOL)inelderlypatientsonPDandHDintheNorthThamesDialysisStudy.♦Design:A12prospectivecohortstudy.♦Setting:Fourhospital-basedrenalunitsinLondon♦Patients:174patientsthatwere70yearsorolderatthestartofdialysis,separatedintotwocohorts:78newpatients(36PD,42HD)thatwererecruitedaft
5、er90daysofchronicdialysis;and96stockpatients(42PD,54HD)thatwerealreadyondialysisduringtherecruitmentperiod.2003peritonealdialysisinternationalQUALITYOFLIFEANDCLINICALOUTCOMESINELDERLYPATIENTSPDVSHDConclusions:ClinicaloutcomesandQOLaresimilarinelderlypeopleonPDandHD.PDisavia
6、bleoptionformorethanacarefullyselectedminorityofelderlypeoplerequiringdialysis.PeritonealDialysisIsAppropriateforElderlyPatientsPeritonealDialysis:AClinicalUpdate.ContribNephrol.Basel,Karger,2006,vol150,pp240-246ElderlypatientsonPDexhibitexcellentcompliancewiththeirtreatmen
7、tregimenanddisplaynoincreaseintherateofinfectiouscomplicationsthoughtheymayhaveaslightincreaseinhospitaldays.Theyeasilyachieveadequacytargets,experiencegoodtechniquesurvivalandtheirnutritionalstatusisatleastasgoodasthatoftheirHDcounterparts.Patientsurvivalvariesaroundthewor
8、ldbutisoverallcomparabletothatofage-matchedpatientsonHD.Qualityoflifemaybesomewhat
