生まれながらの心疾患を持つ成人の腎機能不全の流行,予測要因,および予後値

Konstantinos Dimopoulos¹, Gerhard-Paul Diller, Evdokia Koltsida

¹Adult Congenital Heart Centre, Royal Brompton Hospital & National Heart and Lung Institute, Imperial College School of Medicine, London SW3 6NP, United Kingdom.

Circulation

|April 30, 2008

まとめ

腎機能不全は,成人先天性心疾患患者の間で一般的であり,中等から重度の障害を持つ11人に1人に影響する. この腎機能障害は,死亡リスクを3倍に大幅に増加させます.

科学分野:

心臓病学心臓病学
ネフロロジーは腎臓科です.
生まれながらの心臓病生まれながらの心臓病

背景:

腎不全は,缺血性心臓病と心不全の悪い結果と関連しています.
成人の先天性心疾患 (ACHD) の腎機能障害の罹患率と影響は,まだ十分に研究されていない.

研究の目的:

ACHD患者における腎機能障害の有病率を決定する.
腎機能障害と患者のアウトカム,特に死亡率との関係を調査する.

主な方法:

1102人のACHD患者に対して,腎臓疾患における食事の変化 (MDRD) 方程式を用いて,推定グローメルーラ濾過率 (eGFR) を計算した.
患者は,eGFRに基づいて正常,軽度,中度/重度の腎機能不全グループに分類されました.
コックス回帰を用いて生存率を分析し,混同因子と傾向スコアを調整した.

主要な成果:

ACHD患者の41%は軽度の腎機能不全があり,9%は中度から重度の腎機能不全でした.
減少したeGFRは,アイゼンメンガー生理学の患者 (72% vs. 他者) で有意により一般的であった.
中度/重度の腎機能不全は,死亡率の3倍増加 (HR 3.25) と関連していました.

結論:

腎機能不全は,心臓の問題を超えて広がる,ACHDにおける重要な共病です.
ACHD患者の約11人に1人は,中度から重度のGFR減少を経験し,実質的に高い死亡リスクに直面しています.

さらに関連する動画

07:27

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

07:52

A Mouse 5/6^th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy

Published on: November 7, 2017

関連する概念動画

01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...

01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...

01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...

01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...

01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...

01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...

関連する実験動画