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透析を始める患者の心血管疾患および非心血管疾患による死亡率
Dinanda J de Jager1, Diana C Grootendorst, Kitty J Jager
1Department of Clinical Epidemiology, Leiden University Medical Center, C7-104, PO Box 9600, 2300 RC Leiden, The Netherlands. d.j.de_jager@lumc.nl
JAMA
|October 29, 2009
まとめ
透析を始める患者は,全体的な死亡リスクが著しく高くなります. この増加したリスクは,心血管疾患のみによるものではなく,非心血管疾患による死亡率の増加も伴う.
科学分野:
- ネフロロジーはネフロロジーを用います.
- 公衆衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
背景:
- 心血管疾患による死亡率は,透析患者の主要な死因であり,一般人口の割合を大幅に上回っています.
- 透析患者は,一般の人々と比較して10〜20倍高い死亡リスクを経験します.
研究 の 目的:
- 透析患者の高い死亡率は,心血管疾患のリスクの増加にのみ由来するかどうかを判断する.
- 透析を開始する患者の非心血管疾患による死亡率が同等に上昇しているかどうかを調査する.
主な方法:
- 欧州腎臓協会-欧州透析・移植協会 (ERA-EDTA) の登録データ (1994年~2007年) を利用し,成人透析患者123,407人を対象とした.
- 標準化された心血管疾患および非心血管疾患による死亡指標を用いて,年齢層別死亡率を欧州一般人口 (Eurostat) と比較した.
- ERA-EDTAと国際統計疾病分類第10版 (ICD-10) のコードを用いて死因を分析した.
主要な成果:
- 透析患者では,標準化された心血管 (8.8倍) と非心血管 (8.1倍) の死亡率は,一般の人々と比較して,著しく高かった.
- 非心血管疾患による死亡は,心血管疾患による死亡 (39%) よりも,透析患者における全死亡率のより大きな割合 (51%) を占めていた.
- 透析患者における非心血管死亡率に対する心血管死亡率の相対的過剰は,限界的 (1.09) であった.
結論:
- 透析を開始する患者は,一般的な死亡リスクの増加に直面します.
- 透析患者の高い死亡率は,心血管疾患のみによるものではなく,非心血管疾患による死亡率も重要な役割を果たしている.
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