Causes of initial hemodialysis and characteristics of dialysis initiation among elderly patients with diabetic nephropathy
TU Tianqi1,2, TU Xiaowen1,LI Yanchen1, WANG Huan1, LI Juan1, and LI Wenbo1
1.Department of Nephrology, PLA Rocket Force Characteristic Medical Center, Beijing 100081, China; 2.China Japan Friendship School of Clinical Medicine, Department of Medicine, Peking University, Beijing 100029, China
Abstract：Objective To explore the characteristics of elderly patients who received hemodialysis for the first time and the differences in clinical manifestations and reasons for initiating dialysis between the diabetic nephropathy(DN)group and non-DN group.Methods The etiology, complications and laboratory examination results of 146 elderly patients with hemodialysis were analyzed, who had been treated between January 2014 and December 2018 in the Hemodialysis Center of our hospital. The differences of the above indexes between DN and non-DN patients were studied.Results Diabetic nephropathy (56.8%), chronic glomerulonephritis (15.8%) and hypertension (17.8%) were the main causes of hemodialysis for these elderly patients. The incidences of cardiac insufficiency/edema, anemia, coronary heart disease and cerebral infarction were 79.45%, 41.10%, 29.45% and 19.18%,respectively. During the initial dialysis in DN patients, the serum creatinine 1evel (520.90±244.30)μmol/L was 1ower than that of the non-diabetic group (704.90±204.34) μmol/L, anemia was more severe [(88.44±14.35) g/L vs(95.87±16.28)g/L], and iPTH levels were lower [(186.98±122.59) pg/L vs (253.29±125.80) pg/L]. Cardiac insufficiency/edema was the main cause of HD in DN patients, and serum creatinine levels were lower than those of the non-DN patients. Most patients initiated hemodialysis with central venous catheterization as the blood access.Conclusions Diabetic nephropathy is the dominating cause of initial dialysis among elderly patients, followed by hypertensive nephropathy and chronic glomerulonephritis. Severe complications can occur during hemodialysis. DN patients should initiate HD earlier due to cardiac insufficiency/edema.
涂天琪, 涂晓文, 李燕辰, 王欢, 李娟, 李文博. 老年血液透析患者首次透析病因及老年糖尿病肾病患者启动透析时的特点[J]. 武警医学, 2020, 31(1): 9-11.
TU Tianqi, TU Xiaowen,LI Yanchen, WANG Huan, LI Juan, and LI Wenbo. Causes of initial hemodialysis and characteristics of dialysis initiation among elderly patients with diabetic nephropathy. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(1): 9-11.
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