基于年龄的与年轻成年人硬化值对脏活检和CKD的预后影响
Muhammad S Asghar1, Aleksandar Denic1, Aidan F Mullan2
1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.
Journal of the American Society of Nephrology : JASN
|May 31, 2023
概括
基于年龄的硬化值比年轻成年人基准更有效地识别渐进性慢性病 (CKD). 这项研究发现,与特定年龄规范相比,硬化症的严重程度预测了CKD的进展.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 病理学 病理学 病理学
- 老年学是指老年学的学科.
背景情况:
- 硬化,包括血球硬化和间歇性纤维化/管状缩,是衰老和慢性病 (CKD) 的关键特征.
- 目前尚不清楚基于硬化症识别进展性疾病的最佳值.
- 需要对基于年龄的门和单一的年轻成年人CKD风险门进行比较.
研究的目的:
- 通过对脏活检片段的形态测量分析,确定年轻年龄和基于年龄的脏硬化95百分点值.
- 为了确定这些值是否可以预测在接受切除术或本地活检的患者中进展性CKD的风险.
主要方法:
- 对脏活检图像的形态测量分析 (% 全球性硬化球体,% 间歇性纤维化和管管缩,间歇性纤维化和管管缩焦点密度) 对3020名活体脏捐赠者,1363名脏瘤患者和314名原生脏病患者进行.
- 年轻年龄 (18-29岁) 和基于年龄 (按十年) 的第95百分点值是使用正常血压的供体来定义的.
- 根据年龄调整的渐进性CKD风险与不同类型的硬化相对于特定年龄的规范进行了比较.
主要成果:
- 基于年龄的第95百分点脏硬化症值有显著的变化,在老年人 (≥70岁) 中高出7.1倍至36倍,相比于年轻 (18-29岁) 的正常压力捐赠者.
- 在被认为"与年轻人相比正常"和"与年龄相比正常,但与年轻人相比异常"的腎硬化症患者之间,渐进性CKD风险并没有显著不同.
- 对年龄异常的硬化发现 (%GSG,%IFTA或IFTA焦点密度) 与这两组患者中慢性脏病进展的风险更高显著相关.
结论:
- 基于年龄的脏硬化值比单个年轻成年人值更有效地识别出临床相关的CKD.
- 与特定年龄规范相比,硬化症的严重程度是预测CKD进展的关键因素.
- 这些发现支持使用年龄调整的标准来评估脏活检结果在CKD的背景下.
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