在炎症性肠病患者中,脏和泌尿系统并发症的绝对和相对风险
Yuanhang Yang1, Jonas F Ludvigsson1,2,3, Ola Olén4,5,6
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
The American journal of gastroenterology
|August 11, 2023
概括
患有炎症性肠病 (IBD) 的患者面临慢性病 (CKD),急性损伤 (AKI) 和结石的风险增加. 早期监测和专家护理对于在IBD患者中管理这些脏并发症至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 胃肠病学 胃肠病学
- 流行病学 流行病学
背景情况:
- 炎症性肠病 (IBD) 与各种肠外表现有关.
- 在IBD患者中,脏和泌尿方面的并发症尚未得到充分了解.
- 描述这些风险对于患者管理至关重要.
研究的目的:
- 调查IBD发展与脏并发症风险之间的关联.
- 量化慢性病 (CKD),急性损伤 (AKI) 和IBD患者结石的绝对和相对风险.
- 评估CKD进展的风险,定义为估计膜过率 (eGFR) 或功能衰竭的显著下降.
主要方法:
- 在瑞典斯德哥尔摩 (2006-2018) 进行的一项大型队列研究,对1,682,795名个人进行了研究.
- IBD被视为时间变化的暴露.
- 匹配的队列分析比较IBD病例和对照组 (1:5) 的性别,年龄和基线EGFR.
主要成果:
- 发生IBD与24%更高的CKD诊断风险 (HR 1.24) 和11%更高的CKD进展风险 (HR 1.11) 相关.
- 在10年内,11.8%的IBD病例经历了CKD事件,6.4%的诊断和7.9%的进展.
- 在IBD患者中观察到AKI (HR 1.97) 和结石 (HR 1.69) 的风险增加.
结论:
- 超过10%的IBD患者在诊断后十年内患上CKD.
- 许多IBD患者的CKD病例可能会被诊断码遗漏.
- 显然需要对IBD患者进行系统的功能监测和科/泌尿科转诊协议.
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