| Summary: | 碩士 === 輔英科技大學 === 醫學檢驗生物技術系碩士班 === 105 === Background： Taiwan was the highest incidence and prevalence of End-stage renal disease (ESRD) in the world. Most patients with ESRD underwent chronic dialysis, either hemodialysis (HD) or peritoneal dialysis (PD). Studies comparing the length of survival, outcome and life quality of patients on HD and PD have yielded conflicting results, particularly because of the absence of similar comorbidity burdens in the two groups. Anemia is a common complication among patients with ESRD. About 5-10% of dialysis However, blood transfusion appears to be associated with not only infectious or non-infectious transfusion reactions. The objective of this study was to compare transfusion intensity between PD and HD patients, hospital-based patients at the Blood Transfusion Unit in a regional teaching hospital in Southern Taiwan
Materials and Methods： From the hospital database, patients who were older than 18 years and had received maintenance dialysis for more than 3 months during the study period from January 1, 2005, to December 31, 2015, are enrolled in the dialysis cohort. The dialysis cohort then was divided into HD and PD groups. Patients who received only 2 red-cell units will be defined as “simple transfusion” group and that had more than 2 red-cell units or with other blood component will be defined as “complex transfusion blood” group. In this proposal, we will compare the transfusion intensity between patients treated with PD and HD in regional teaching hospital.
Result：Demographic data analysis showed that age was a major consideration in selecting hemodialysis modalities for renal dialysis patients in the hospital. In young patients (18-40 years), peritoneal dialysis was predominant (HD vs PD : 6.02% vs 22.06%, p<0.0001). The type and amount of comorbidities do not affect the selection of dialysis modality. In the propensity scores before and after matching, the ratio of transfused red blood cells (HD vs PD : 63.69% vs 41.18%, p<0.0001), the average of transfused blood amount (HD vs PD : 5.73 ± 18.08 units / year vs 2.62 ± 7.0 units / year) and the frequency of transfused red blood cells (HD vs PD : 1.79 ± 3.15 times / year vs 0.87 ± 1.85 times / year; p<0.0001), showed a significant increase in HD patients. Multivariate regression analysis of the risk of transfusion, in propensity scores before and after matching, the results show that hemodialysis and gastrointestinal bleeding is the cause of ESRD transfusion therapy is a major risk factor.
Conclusion：Patients underwent HD have higher risk of RBC transfusion than PD patients. Gastrointestinal bleeding is the major risk factor for RBC transfusion in dialysis patients. PD treatment is more favored in patients with ESRD and who concerned about the issue of blood transfusion. We hope to provide helpful information from our results to clinicians and patients with ESRD.
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