関連する実験動画
流体収縮は,長期的な血液透析を受けている患者の心血管疾患による死亡率と関連しています
Kamyar Kalantar-Zadeh1, Deborah L Regidor, Csaba P Kovesdy
1Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W Carson St, C1-Annex, Torrance, CA 90509-2910, USA. kamkal@ucla.edu
Circulation
|January 28, 2009
まとめ
ヘモダイアリス患者の体液保持は,あらゆる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. 治療中の慢性腎臓病患者の生存率を改善するために,インターダイアリシスによる体重増加の管理は極めて重要です.
科学分野:
- ネフロロジーは腎臓科
- 心臓病学 心臓病学
- 公衆衛生は公衆衛生である.
背景:
- 慢性腎臓病 (5期) の患者で,血液透析を受けている患者は,心不全の患者と,特に液体収縮と高い死亡率で類似点を持っています.
- ボリュームオーバーロードは,心不全患者の有害な結果の予測要因として知られています.
研究 の 目的:
- ヘモダイアリシス患者におけるインターダイアリシス液の増量と全原因および心血管生存の関連性を調査する.
- この集団で,より大きな流体保持が,より悪い生存結果と相関するかどうかを判断する.
主な方法:
- 米国における34,107人の血液透析患者の2年間の死亡率データを分析した.
- 2001年7月から2003年6月までの体重増加を調査し,0.5kgのインクリメントに分割したインターダイアリスティック体重増加の分類.
- 人口統計と栄養不良-炎症複合体の代理人に対する多変量調整.
主要な成果:
- 患者の86%が,1. 5kgを超えるダイエット間体重増加を経験しました.
- 調整されていない分析では,より高い体重増加がより良い栄養状態と生存率と関連していることが示された.
- 多変量調整の後,体重増加の増加は,全原因および心血管疾患による死亡のリスクの増加と関連していました.
結論:
- ヘモダイアリスセッション間のより大きな流体保持は,全原因および心血管疾患による死亡のリスクの増加と関連しています.
- 血液透析患者の心血管生存に対する液体収留の影響の根底にあるメカニズムは,心不全の患者と同じかもしれない.
- これらのメカニズムとその臨床的影響を調査するために,さらなる研究が必要である.
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