コミュニティベースの集団における新発症性腎臓病の予測要因
Caroline S Fox1, Martin G Larson, Eric P Leip
1National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Mass 01702, USA. caroline@fram.nhlbi.nih.gov
JAMA
|February 19, 2004
まとめ
年齢,糖尿病,高血圧などの心血管疾患のリスク要因は,新規発症した腎臓疾患を予測します. 低血球過濾率 (GFR) の個人をモニタリングすることは,早期発見と管理に不可欠です.
科学分野:
- ネフロロジーは腎臓科です.
- 心臓病学 心臓病学
- エピデミオロジー エピデミオロジー
背景:
- 腎疾患は,心血管疾患と末期腎疾患のリスクを大幅に増加させます.
- 腎臓病の危険因子を理解することは極めて重要ですが,まだ十分に研究されていません.
研究 の 目的:
- 一般集団における新発症性腎疾患の発症の主要な予測要因を特定する.
- 心血管疾患の危険因子と腎臓疾患の発生率との関連を調査する.
主な方法:
- 2585人の参加者を対象とした縦断的なコホート研究で,最初は腎臓疾患のない状態でした.
- 腎臓疾患は,腎臓疾患における食事の変更 (MDRD) 方程式を使用して評価され,特定の百分位以下のグルメルフィルタレーション率 (GFR) によって定義されます.
- ステップウィズロジスティック回帰では,新規発症性腎臓疾患を予測するためのベースラインと長期的な平均リスク要因を分析した.
主要な成果:
- 18.5年間の追跡期間中,9.4%の参加者が腎臓疾患を発症しました.
- 予測要因には,初期年齢,低GFR,高ボディマス指数,糖尿病,喫煙が含まれていた.
- 腎臓疾患を予測する長期的な要因は,高血圧,低高密度リポタンパク質コレステロール,糖尿病でした.
- GFRが軽く低下した (<90 mL/min/1.73 m2) は,腎臓疾患を発症する確率が3倍に増加したことを示した.
結論:
- 確立された心血管疾患の危険因子は,新規発症した腎臓疾患の発生と有意に関連しています.
- GFRが軽く低下した個人は,腎臓病への潜在的な進行を注意深く監視する必要があります.
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