Survival and associated risk factors of patients on chronic haemodialysis in Lithuania ; Pacientų, sergančių galutiniu inkstų nepakankamumu bei gydomų hemodializėmis, išgyvenimas ir su juo susiję veiksniai

Ingrida

Sujets

• ESRD
• Medicine
• Risk factor
• Survival

Informations

• Publié par: kaunas_university_of_medicine
• Publié le: 01 janvier 2010
• Nombre de lectures: 31
• Poids de l'ouvrage: 2 Mo

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KAUNAS UNIVERSITY OF MEDICINE
Asta Stankuvienė
SURVIVAL AND ASSOCIATED
RISK FACTORS OF PATIENTS
ON CHRONIC HAEMODIALYSIS
IN LITHUANIA
Summary of Doctoral Dissertation
Biomedical Science, Medicine (07 B)
Kaunas, 2010
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Dissertation was carried out in Kaunas University of Medicine, during 2006–
2010.
Scientific Supervision
Assoc. Prof. Dr. Inga Arūnė Bumblytė (Kaunas University of Medicine, Biomedi-
cal Sciences, Medicine – 07 B).
Consultant
Prof. Dr. Ramunė Kalėdienė (Kaunas University of Medicine, Biomedical Sciences,
Public Health – 10 B).
The Dissertation will be defended at the Medical Research Council of Kaunas
University of Medicine:
Chairman:
Prof. Dr. Žilvinas Padaiga (Kaunas University of Medicine, Biomedical Sciences,
Medicine – 07 B, Public Health – 10 B).
Members:
Prof. Dr. Arvydas Laurinavičius (Vilnius University, Biomedical Sciences, Medi-
cine – 07 B)
Assoc. Prof. Dr. Daimantas Milonas (Kaunas University of Medicine, Biomedical
Sciences, Medicine – 07 B)
Assoc. Prof Dr. Asta Baranauskaitė (Kaunas Universie, Biomedicalcine – 07 B)
Prof. Dr. Boleslaw Rutkowski (Gdansk University of Medicine, Poland, Biomedi-
cal Sciences, Medicine – 07 B).
Opponents:
Assoc. Prof. Dr. Aivaras Jonas Matjošaitis (Kaunas University of Medicine, Bio-
medical Sciences, Medicine – 07 B)
Dr. Augustina Jankauskienė (Vilnius University, Biomedical Sciences, Medicine –
07 B).
The Dissertation will be defended at the open session of the Medical Research
Council in the Symposia hall of the Kaunas University of Medicine on 4 May, 2010,
at 12 h.
Address: Eivenių str. 4, LT-50009 Kaunas, Lithuania.
The summary of the dissertation has been sent on 02 April 2010.
The full text of the doctoral dissertation is available in the Library of Kaunas
University of Medicine.
Address: Eivenių str. 6, LT-50161 Kaunas, Lithuania.
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KAUNO MEDICINOS UNIVERSITETAS
Asta Stankuvienė
PACIENTŲ, SERGANČIŲ GALUTINIU
INKSTŲ NEPAKANKAMUMU
BEI GYDOMŲ HEMODIALIZĖMIS,
IŠGYVENIMAS IR SU JUO SUSIJĘ VEIKSNIAI
Daktaro disertacijos santrauka
Biomedicinos mokslai, medicina (07 B)
Kaunas, 2010
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Disertacija rengta 2006–2010 metais Kauno medicinos universitete.
Mokslinis vadovas
Doc. dr. Inga Arūnė Bumblytė (Kauno medicinos universitetas, biomedicinos
mokslai, medicina – 07 B).
Konsultantas
Prof. dr. Ramunė Kalėdienė (Kauno medicinos universitetas, biomedicinos mokslai,
visuomenės sveikata – 10 B).
Disertacija ginama Kauno medicinos universiteto medicinos mokslo krypties
taryboje:
Pirmininkas
Prof. habil. dr. Žilvinas Padaiga (Kauno medicinos universitetas, biomedicinos
mokslai, medicina – 07 B, visuomenės sveikata – 10 B)
Nariai:
Prof. dr. Arvydas Laurinavičius (Vilniaus universitetas, biomedicinos mokslai, me-
dicina – 07 B)
Doc. dr. Daimantas Milonas (Kauno medicinos universitetas, biomedicinos moks-
lai, medicina – 07 B)
Doc. dr. Asta Baranauskaitė (Kauno medicinos universitetas, biomedicinos moks-
lai, medicina – 07 B)
Prof. dr. Boleslaw Rutkowski (Gdansko medicinos universitetas, Lenkija, biomedi-
cinos mokslai, medicina – 07 B)
Oponentai:
Doc. dr. Aivaras Jonas Matjošaitis (Kauno medicinos universitetas, biomedicinos
mokslai, medicina – 07 B)
Dr. Augustina Jankauskienė (Vilniaus universitetas, biomedicinos mokslai, medici-
na – 07 B)
Disertacija bus ginama viešame Medicinos krypties tarybos posėdyje 2010 m. gegu-
žės 4 d. 12 val.
Kauno medicinos universiteto Mokomojo laboratorinio korpuso Simpoziumų salėje.
Adresas: Eivenių g. 4, LT-50009 Kaunas, Lietuva.
Disertacijos santrauka išsiuntinėta 2010 m. balandžio 2 d.
Disertaciją galima peržiūrėti Kauno medicinos universiteto bibliotekoje.
Adresas: Eivenių g. 6, LT-50161 Kaunas, Lietuva.
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ABBREVIATIONS
ANZDATA – Australian and New Zealand Dialysis and Transplant
Registry
AUC – area under the curve
CORR – Canadian Organ Replacement Registry
CRP – C-reactive protein
DOPPS – Dialysis Outcomes and Practice Patterns Study
ERA-EDTA – European Renal Association Registry
Registry
ESRD – end stage renal disease
Hb – haemoglobin
HD – haemodialysis
Kt/V – HD adequacy index
K/DOQI – Kidney Disease Outcomes Quality Initiative
n – sample size
PD – peritoneal dialysis
PTH – parathyroid hormone
r – correlation coefficient
ROC curve – receiver operating characteristic curve
RR – relative risk
RRT – renal replacement therapy
USA – United States of America
USRDS – United States Renal Data System Registry
95% CI – 95% confidence interval
INTRODUCTION
End-stage renal disease (ESDR) is highly prevalent worldwide, with
more than 1 million patients undergoing renal replacement therapies
(RRT), which are a life-saving treatment for such patients. The main
factors contributing to the continued growth are the universal ageing of
populations, multimorbidity, higher life expectancy of treated ESRD
patients and increasing access of patient populations to RRT in countries
in which access had previously been limited. Dialysis is still the most
common treatment, partly due to insufficient kidney donation to meet the
demand for renal transplants. At the end of 2004, 1 783 000 people
worldwide were undergoing treatment for ESRD; 1 371 000 (i.e. 77%)
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were on dialysis treatment. Analysis of the type of treatment received by
dialysis revealed that haemodialysis (HD) remains the most common
treatment modality in all regions of the world. At the end of 2004, 89% of
patients worldwide were treated by HD and 11% were undergoing
peritoneal dialysis (PD) treatment [Grassman et al. 2005].
In most countries, renal registries are responsible for ESRD data
collection, analysis and reporting. The most important factor for the renal
registries, which influences the collection of annual data, is the response
rate to the questionnaire. In some registries, the submission of the data is
mandatory and linked to the reimbursement of treatments performed in
dialysis facilities. For example, in the United States, the Medicare only
reimburses the cost of dialysis treatment after it receives patient data,
which are then supplied to the USRDS. Other registries work based on
voluntary submission of data. In such cases, only a few renal registries,
such as the ANZDATA registry, CORR and the Japanese Society for
Dialysis Therapy, receive data from more than 90% of all dialysis facili-
ties. Other voluntary national and international registries have a response
rate to the questionnaire of the dialysis centres lower