KIDNEY INT:癫痫和抗癫痫药物增加了透析患者的全因死亡率

2019-05-18 xing.T 网络

由此可见,接受透析治疗的ESRD患者癫痫发病率很高,与没有癫痫的患者相比,死亡风险增加。因此,适当的多学科护理、治疗和药物选择可以降低癫痫透析患者的死亡率。

癫痫发作与尿毒症有关,但与没有癫痫的患者相比,关于终末期肾病(ESRD)患者癫痫发作的患病率、治疗和结局数据很少。近日,肾脏病领域权威杂志kidney international上发表了一篇研究文章,研究人员使用美国肾脏数据系统进行了一项回顾性队列研究,以评估有或没有癫痫诊断的ESRD患者的死亡率和抗癫痫药物处方情况。

研究人员使用了具有稳健方差的改进泊松回归来估计癫痫状态与死亡率之间的关联,并通过神经学咨询评估效果改善情况。此外,还评估了抗癫痫药物与癫痫患者死亡率的关系。

该队列纳入了148294名ESRD患者中,13094名(8.8%)符合基于索赔的癫痫定义。在癫痫患者中,2013-2014年期间80.9%的患者服用抗惊厥药或乙内酰脲,而未患癫痫的患者为33.3%。调整混杂因素后,癫痫患者的死亡风险为1.11(95%可信区间:1.07-1.14),高于无癫痫患者。癫痫诊断与未进行神经病学咨询的患者死亡风险增加14%相关(相对风险为1.14 [95%置信区间:1.08-1.19]),但神经病学咨询患者的这种风险减弱(1.07 [1.03-1.11])。与其他抗癫痫药物相比,加巴喷丁对癫痫诊断患者的处方与死亡率增加有关(1.08 [1.01-1.15])。

由此可见,接受透析治疗的ESRD患者癫痫发病率很高,与没有癫痫的患者相比,死亡风险增加。因此,适当的多学科护理、治疗和药物选择可以降低癫痫透析患者的死亡率。 

原始出处:

Salina P. Waddy,et al.Epilepsy and anti-seizure medications increase all-cause mortalityin dialysis patients in the United States.kidney-international.2019.https://doi.org/10.1016/j.kint.2019.04.033

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1716048, encodeId=3f331e1604867, content=<a href='/topic/show?id=a4175555e85' target=_blank style='color:#2F92EE;'>#抗癫痫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55557, encryptionId=a4175555e85, topicName=抗癫痫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=695a32117432, createdName=shuangle, createdTime=Mon Apr 06 12:11:00 CST 2020, time=2020-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251513, encodeId=adee1251513b9, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414711, encodeId=e6fe1414e1195, content=<a href='/topic/show?id=94a85555919' target=_blank style='color:#2F92EE;'>#抗癫痫药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55559, encryptionId=94a85555919, topicName=抗癫痫药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05ca3082114, createdName=mgqwxj, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570645, encodeId=ba7e15e064594, content=<a href='/topic/show?id=e53d94835a5' target=_blank style='color:#2F92EE;'>#透析患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94835, encryptionId=e53d94835a5, topicName=透析患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b0915676167, createdName=ewsr6, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603131, encodeId=d5471603131fe, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c36e18990621, createdName=gwc389, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1716048, encodeId=3f331e1604867, content=<a href='/topic/show?id=a4175555e85' target=_blank style='color:#2F92EE;'>#抗癫痫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55557, encryptionId=a4175555e85, topicName=抗癫痫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=695a32117432, createdName=shuangle, createdTime=Mon Apr 06 12:11:00 CST 2020, time=2020-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251513, encodeId=adee1251513b9, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414711, encodeId=e6fe1414e1195, content=<a href='/topic/show?id=94a85555919' target=_blank style='color:#2F92EE;'>#抗癫痫药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55559, encryptionId=94a85555919, topicName=抗癫痫药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05ca3082114, createdName=mgqwxj, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570645, encodeId=ba7e15e064594, content=<a href='/topic/show?id=e53d94835a5' target=_blank style='color:#2F92EE;'>#透析患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94835, encryptionId=e53d94835a5, topicName=透析患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b0915676167, createdName=ewsr6, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603131, encodeId=d5471603131fe, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c36e18990621, createdName=gwc389, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1716048, encodeId=3f331e1604867, content=<a href='/topic/show?id=a4175555e85' target=_blank style='color:#2F92EE;'>#抗癫痫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55557, encryptionId=a4175555e85, topicName=抗癫痫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=695a32117432, createdName=shuangle, createdTime=Mon Apr 06 12:11:00 CST 2020, time=2020-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251513, encodeId=adee1251513b9, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414711, encodeId=e6fe1414e1195, content=<a href='/topic/show?id=94a85555919' target=_blank style='color:#2F92EE;'>#抗癫痫药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55559, encryptionId=94a85555919, topicName=抗癫痫药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05ca3082114, createdName=mgqwxj, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570645, encodeId=ba7e15e064594, content=<a href='/topic/show?id=e53d94835a5' target=_blank style='color:#2F92EE;'>#透析患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94835, encryptionId=e53d94835a5, topicName=透析患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b0915676167, createdName=ewsr6, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603131, encodeId=d5471603131fe, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c36e18990621, createdName=gwc389, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1716048, encodeId=3f331e1604867, content=<a href='/topic/show?id=a4175555e85' target=_blank style='color:#2F92EE;'>#抗癫痫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55557, encryptionId=a4175555e85, topicName=抗癫痫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=695a32117432, createdName=shuangle, createdTime=Mon Apr 06 12:11:00 CST 2020, time=2020-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251513, encodeId=adee1251513b9, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414711, encodeId=e6fe1414e1195, content=<a href='/topic/show?id=94a85555919' target=_blank style='color:#2F92EE;'>#抗癫痫药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55559, encryptionId=94a85555919, topicName=抗癫痫药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05ca3082114, createdName=mgqwxj, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570645, encodeId=ba7e15e064594, content=<a href='/topic/show?id=e53d94835a5' target=_blank style='color:#2F92EE;'>#透析患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94835, encryptionId=e53d94835a5, topicName=透析患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b0915676167, createdName=ewsr6, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603131, encodeId=d5471603131fe, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c36e18990621, createdName=gwc389, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1716048, encodeId=3f331e1604867, content=<a href='/topic/show?id=a4175555e85' target=_blank style='color:#2F92EE;'>#抗癫痫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55557, encryptionId=a4175555e85, topicName=抗癫痫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=695a32117432, createdName=shuangle, createdTime=Mon Apr 06 12:11:00 CST 2020, time=2020-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251513, encodeId=adee1251513b9, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414711, encodeId=e6fe1414e1195, content=<a href='/topic/show?id=94a85555919' target=_blank style='color:#2F92EE;'>#抗癫痫药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55559, encryptionId=94a85555919, topicName=抗癫痫药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05ca3082114, createdName=mgqwxj, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570645, encodeId=ba7e15e064594, content=<a href='/topic/show?id=e53d94835a5' target=_blank style='color:#2F92EE;'>#透析患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94835, encryptionId=e53d94835a5, topicName=透析患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b0915676167, createdName=ewsr6, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603131, encodeId=d5471603131fe, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c36e18990621, createdName=gwc389, createdTime=Mon May 20 03:11:00 CST 2019, time=2019-05-20, status=1, ipAttribution=)]
    2019-05-20 gwc389

相关资讯

我不是癫痫好多年,我只想潇洒走一回!

20多年的怪病仅用了一种药就治好了!

骨搬移术后癫痫发作致股骨颈骨折1例

39岁男性患者,2016年8月7日摔伤致右胫腓骨远端开放骨折,就诊于我院急诊科,行急症清创+外固定术;术后患者右胫腓骨远端大块骨质缺损伴伤口感染,行抗生素骨水泥填充+VSD覆盖术;后行右胫骨骨搬移术,术后坚持骨性延长每日延长1mm,直至右胫腓骨远端达到骨性对接,每周摄X线片复查,停止延长后,准予出院静养,定期来院复查。患者于2017年9月17日再次门诊就诊,患者自诉于半月前无明显诱因夜间癫痫发作,

患儿半年内多次呕吐后抽搐 不是癫痫那是什么?

儿科病房收了一个比较奇怪的病例:男孩,年龄13个月,反复惊厥发作半年多,患儿来自江西。患儿生后6个月开始有发作性意识丧失伴四肢强直或痉挛性抽搐,历时数秒至数分钟。这样的发作半年多时间已经有过4回。

丙泊酚诱发无痛人流术后癫痫持续状态1例

患者,女,28岁,体重52Kg,因G2P1孕42天,拟行人工流产术。体格检查无异常,否认高血压、心脏病、糖尿病、癫痫病史,否认药物过敏史。入室后常规检测,生命体征平稳,开放外周静脉通路,静脉注射丙泊酚140mg(生产厂家:四川国瑞药业有限公司)内含2%利多卡因2ml。

Nat Med:局灶性癫痫的新型基因疗法

英国伦敦大学学院神经学研究所的Andreas Lieb及其同事尝试在大鼠身上使用病毒介导的基因疗法,以检测它是否能减少癫痫发作以及耐受性如何。这项研究成果发表在著名期刊《Nature Medicine》上。

癫痫发作,也许是寄生虫惹的祸!

癫痫的发病机制极为复杂,多种因素如遗传、肿瘤、感染、外伤等均可导致癫痫的发生。所以在癫痫的诊疗过程中,怎样辨明病因是神经科医生面临的一大挑战。在遇上较为罕见的情况时,更需小心谨慎,避免漏诊误诊。