末期腎臟病病人接受預先腹膜透析植管的成效

Outcomes of Stepwise Initiation of Peritoneal Dialysis in Patients with End-Stage Renal Disease

根據2021年台灣腎臟病年報資料，2019年腹膜透析發生率為9.4%。然而，很少研究比較接受預先腹膜透析植管(stepwise initiation of peritoneal dialysis, SIPD)和傳統腹膜透析植管(conventional peritoneal dialysis, CPD)的結果。先前的研究報告中，與CPD組相比，SIPD組腹膜透析相關腹膜炎、導管滲漏和導管出口部位感染的發生率較低。為了進一步探討兩組之間的比較，對接受腹膜透析治療的末期腎臟病病人進行了系統回顧。結果顯示，與CPD組相比，SIPD組的腹膜災發生率可降低1.72百人月，腹膜炎發生風險降低了23%及導管滲漏的發生率可降低5.13百人月，導管滲漏發生的風險降低了15%。因此，我們建議選擇腹膜透析治療的末期腎臟病病人應接受SIPD，以降低腹膜透析導管置入相關併發症的風險。建議未來的研究應該評估SIPD與CPD的成本效益、住院時間和患者滿意度等方向探討，提升醫療照護品質。

According to the 2021 annual report on kidney disease in Taiwan, the incidence of peritoneal dialysis in 2019 was 9.4%. However, few studies have compared the outcomes of systematic initiation of peritoneal dialysis (SIPD) and conventional initiation of peritoneal dialysis (CPD). Previous studies have reported that the incidence of PD-related peritonitis, catheter leakage, and exit site infections was lower in the SIPD group compared to the CPD group. To further explore the comparison between the two groups, a systematic review was conducted in end-stage renal disease patients who received peritoneal dialysis therapy. The results showed that compared with the CPD group, the incidence of peritonitis in the SIPD group was reduced by 1.72 hundred person-months, the risk of peritonitis was reduced by 23%, and the incidence of catheter leakage was reduced by 5.13 hundred person-months, and the risk of catheter leakage was reduced by 15%. Therefore, we suggest that end-stage renal disease patients who choose peritoneal dialysis should receive SIPD to reduce the risk of complications associated with catheter placement. Future studies should evaluate the cost-effectiveness, hospitalization duration, and patient satisfaction of SIPD versus CPD.