23例终末期肾病患者透析时机影响因素的调查分析

目的 评估基层医院终末期肾病患者的透析时机,探讨过晚透析的影响因素及改进措施.方法 以郸城县人民医院透析科2007年7月1日至2009年7月1日开始透析的所有非糖尿病性终末期肾病患者为研究对象,分析其开始透析时血肌酐、肾小球滤过率、尿毒症症状、尿毒症心、脑血管并发症、首次透析情况,调查过晚透析的影响因素.结果 (1)进入透析时肾小球滤过率平均为(3.6±0.9)ml/min;(2)所有患者均有尿毒症并发症、营养状态下降,30.4%患者需急诊透析;(3)91.3%患者系透析时机过晚,其原因以经济原因多见,其次与就诊晚和认识不足有关.结论 基层医院开始血液透析的终末期肾病患者多数为透析时机过晚.经济原因、就诊过晚及认识不足是影响透析时机的关键因素.

The influencing factor of timing of dialysis in patients with non - diabetic end stage renal disease in the hospital of basic level

Objective To evaluate the timing of hemodialysis in patients with end stage renal dis-ease (ESRD) and to approach its influencing factors and improving measure. Methods A cohort of 23 pa-tients with non- diabetic ESRD in the People' s hospital of Dancheng country during July 1st, 2007 to July 1st, 2009 were studied. The data of serum creatinine before hemodialysis, GFR[measured by the MDRD for-mula (eGFR)], symptom of urinaemia, cardiac and cerebrovascular complication and also the condition of the fast hemodialysis were collected in order to find out the factors that affect the delay of hemodialysis. the patients had complications of urinaemia, else with the dystrophy, and 30.4% of them required emergent hemodialysis. (3)The timig of hemodialysis was late in 91.3% patients, mainly cause of the delayed dialysis was financial reasons, then was late diagnosis and shortage of related ESRD knowledge. Conclusions Most of the ESRD patients in country hospital were late for homodialysis. The key rented factors are economic status, delayed diagnosis and shortage of rented ESRD knowledge in patiens, which result in being late for hospital.