在5期慢性病的腹膜透析和非透析患者之间比较左心室透析功能:一种倾向性得分匹配分析
Byoung-Geun Han1, Jae Hee Seol2, Sooyeon Choi1
1Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea.
Journal of clinical medicine
|August 12, 2023
概括
在非透析慢性病 (CKD) 患者中,液体过载是左心室透析功能障碍 (LVDD) 的关键因素. 这与持续的门诊腹膜透析 (CAPD) 患者形成鲜明对比,在这种情况下,液体过载.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 内部医学 内部医学
背景情况:
- 慢性病 (CKD) 与左心室扩张性功能障碍 (LVDD) 的高患病率有关.
- 在CKD患者中,LVDD增加了心力衰竭和死亡的风险.
- 流体过载是患有功能障碍的患者LVDD的潜在原因.
研究的目的:
- 为了评估液体过载作为CKD患者LVDD的独立风险因素.
- 为了比较流体过载对E/e'比率 (扩张功能标志物) 的影响,在连续门诊腹膜透析 (CAPD) 和非透析CKD第5期 (CKD5) 患者之间进行.
- 根据透析状态调查液体过载和LVDD之间的关联.
主要方法:
- 使用倾向分数匹配 (PSM) 来创建可比的CAPD和CKD5患者组 (每组n=111).
- 使用生物阻抗光谱学 (OH/ECW) 量化液体平衡.
- 左心室扩张功能障碍 (LVDD) 通过心声回声扫描 (E/e'比>15) 诊断出来.
主要成果:
- 与CAPD患者相比,CKD5患者的E/e'比率显著更高 (p=0.002).
- 流体过载 (OH/ECW) 在CKD5患者中独立与LVDD相关 (p=0.047) 但在CAPD患者中没有 (p=0.087).
- 在CKD5组的LVDD患者的OH/ECW显著更高 (p=0.001),不同于CAPD组 (p=0.517).
结论:
- 导致LVDD的因素在透析依赖和非透析依赖的CKD患者之间有所不同.
- 液体过载是非透析CKD5期患者LVDD的独立风险因素.
- 早期监测和流体状况的管理对于缓解晚期CKD中LVDD至关重要.
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