末期性腎疾患患者の周周動脈疾患:透析結果と実践パターン研究 (DOPPS) の観察結果
Sanjay Rajagopalan1, Santo Dellegrottaglie, Anna L Furniss
1Division of Cardiovascular Medicine, 473 W 12th Ave, Ohio State University, Columbus, OH 43202, USA. Sanjay.Rajagopalan@osumc.edu
Circulation
|October 25, 2006
まとめ
周辺動脈疾患 (PAD) は,血液透析患者の約25%に影響を与え,死亡,心血管疾患,入院のリスクを高めます. PADはまた,患者の健康関連の生活の質を大幅に低下させます.
科学分野:
- ネフロロジーは腎臓科
- 心血管医学 心血管医学
- 公衆衛生は公衆衛生である.
背景:
- 末期腎疾患 (ESRD) の患者は,心血管合併症のリスクが高まります.
- 周辺動脈疾患 (PAD) は,この集団において重大な懸念事項である.
- PADの罹患率と影響を理解することは,患者のアウトカムを改善するために非常に重要です.
研究 の 目的:
- 国際的な血液透析患者コホートにおけるPADの罹患率を決定する.
- 死亡率と入院率を含む,PADと予後との関連性を調査する.
- 血液透析患者の健康関連生活の質 (HRQOL) に対するPADの影響を評価する.
主な方法:
- 29,873人の血液透析患者を対象とした国際透析結果と実践パターン研究 (DOPPS) のデータ分析.
- PADの相関性を特定するためのロジスティック回帰.
- PADと死亡率/入院リスクとの関連性を評価するためのコックス回帰モデル.
- 患者の報告したアウトカムを評価するためのHRQOLアンケート.
主要な成果:
- PADは患者の25.3%で診断され,顕著な地理的な変動がありました.
- PADの有意な相関値には,年齢,男性の性別,糖尿病,高血圧,喫煙,および血液透析の持続期間が含まれています.
- PADの診断は,全因死亡率 (HR=1.36),心臓死亡率 (HR=1.43),入院率 (HR=1.19) の増加と関連していました.
- PADの患者は,HRQOLのアンケートで身体的健康スコアが著しく低下した (P<0.0001).
結論:
- 外周動脈疾患は,血液透析患者の間で非常に一般的です.
- PADは,心血管疾患による死亡率,罹病率,入院リスクの有意な増加と独立して関連しています.
- PADは,血液透析を受けている患者の健康関連の生活の質に悪影響を及ぼします.
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