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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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末期腎疾患における生存に対する大動脈硬さの影響
J Blacher1, A P Guerin, B Pannier
1Service de Médecine, Hôpital Broussais, Paris, France.
Circulation
|May 11, 1999
まとめ
大動脈脈波速度 (PWV) で測定される大動脈硬さの増加は,末期腎疾患 (ESRD) の患者の死亡率の強い予測因子です. 高いPWVは,全原因および心血管疾患による死亡のリスクを大幅に増加させます.
科学分野:
- 心血管医学 心血管医学
- ネフロロジーは腎臓科です.
- 血管生物学 血管生物学
背景:
- 末期腎疾患 (ESRD) は,高い心血管疾患および死亡率と関連しています.
- 動脈の硬化,インティマ・メディアの厚さ,脈圧は,ESRD患者における主要な動脈の変化です.
- ESRDにおける死亡率に対する大動脈パルス波速度 (PWV) の予測値は,以前調査されていなかった.
研究 の 目的:
- 大動脈脈波速度 (PWV) の増加が末期腎疾患 (ESRD) の患者における全因および心血管疾患による死亡率を予測するかどうかを調査する.
主な方法:
- ヘモダイアリスを受けた241人のESRD患者のコホートは,平均72ヶ月間追跡されました.
- 大動脈PWVは,ベースラインでドップラー超音波を用いて測定されました.
- コックス回帰分析を使用して,死亡率の予測要因を特定し,混同要因に調整しました.
主要な成果:
- 年齢と大動脈PWVは,全因および心血管疾患による死亡率の両方の有意な予測要因として浮上した.
- 増加した大動脈PWV (>12.0m/s vs <9.4m/s) は,全因死亡の5.4倍の増加リスクと,心血管死亡の5.9倍の増加リスクと関連していました.
- PWVの1m/s増加は,調整後の全因死亡リスクの39%増加と関連していました.
結論:
- 大動脈PWVによって示される大動脈硬さの増加は,ESRD患者における全因および心血管疾患による死亡率の強力な独立した予測因子です.
- 大動脈PWV測定は,ESRD患者にとって貴重な予後情報を提供します.
- これらの発見は,ESRDにおける心血管疾患のリスクを管理する際に,動脈の硬さを評価することの重要性を強調しています.
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