急性腎臓損傷と急性重度の高血圧における心血管的アウトカム
Lynda A Szczech1, Christopher B Granger, Joseph F Dasta
1Department of Medicine, Division of Nephrology, Duke University Medical Center, Box 3646, Durham, NC 27710, USA. szcze001@mc.duke.edu
Circulation
|May 12, 2010
まとめ
急性重度の高血圧および慢性腎臓病の患者は,急性腎臓損傷 (AKI) とより悪い結果のリスクが高くなります. AKIは,これらの患者の罹病率と死亡率を大幅に増加させます.
科学分野:
- ネフロロジーは腎臓科
- 心臓病学 心臓病学
- クリティカルケア・メディシン
背景:
- 急性重度の高血圧における結末に対する腎臓機能障害の影響は十分に理解されていません.
- 慢性腎臓病 (CKD) は,腎臓の機能に影響を与える一般的な疾患です.
- 急性腎臓損傷 (AKI) は,腎臓機能の著しい低下を表します.
研究 の 目的:
- 患者のアウトカムとの基礎的なCKD (eGFR) とAKIとの関連性を評価する.
- 急性重度の高血圧で入院した患者のアウトカムを分析する.
主な方法:
- STAT (Studying the Treatment of Acute Hypertension) レジストリからのデータを活用した.
- 静脈注射抗高血圧剤で治療された急性重度の高血圧を有する患者を登録した.
- 患者の分類は,入院中にGFRとAKIの存在によるものです.
主要な成果:
- 急性重度の高血圧の患者では,CKDの高い罹患率 (79%) が観察されました.
- CKD患者には,心不全,心筋梗塞,AKIのリスクが増加しました.
- AKIは,心不全,心停止,90日間の死亡率のリスクの増加と関連していました.
- 入院中のeGFRの低下は,独立して死亡リスクの増加を予測しました.
結論:
- CKDは,急性重度の高血圧入院における頻繁な併発症である.
- AKIは一般的な合併症であり,特に既存のCKDの患者では特にそうである.
- AKIは,この患者集団における罹病率と死亡率の増加と関連しています.
関連する概念動画
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