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静脉二碳酸盐和CKD进展:通过基于组的轨迹模型进行纵向分析
Graziella D'Arrigo1, Mercedes Gori2, Daniela Leonardis1
1CNR-IFC, Reggio Cal, Italy.
Clinical kidney journal
|November 2, 2023
概括
保持较高的血清二碳酸盐水平可能会减缓慢性病 (CKD) 的进展. 这项研究发现,较高的二碳酸盐轨迹与慢性病患者衰竭风险降低有关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内部医学 内部医学
- 临床研究 临床研究
背景情况:
- 在动物模型中,代谢性酸会加速慢性病 (CKD) 的进展.
- 目前对二碳酸盐对脏结果的影响的临床试验有限.
- 观察性研究通常依赖于单个二碳酸盐测量,缺乏纵向数据.
研究的目的:
- 为了研究重复的血清二碳酸盐水平与CKD患者的结局之间的纵向关系.
- 使用基于组的轨迹建模 (GBTM) 将CKD患者分为不同的二碳酸盐水平轨迹.
- 评估这些二碳酸盐轨迹与复合结局之间的关联.
主要方法:
- 基于组的轨迹建模 (GBTM) 用于识别随时间推移的二碳酸盐水平模式.
- 分析了528名患有2-5期CKD的患者队列.
- 考克斯回归模型被用来评估二碳酸盐轨迹与事件 (eGFR减少,透析或移植) 之间的关联.
主要成果:
- 确定了四种不同的二碳酸盐轨迹:低,中等,中等高和高.
- 从最低到最高的二碳酸盐轨迹观察到事件危险率的剂量依赖性下降.
- 与最低轨迹组相比,双碳酸盐轨迹最高组的患者在调整混因子后,与最低轨迹组相比,复合结点的风险降低了63%.
结论:
- 较高的血清二碳酸盐轨迹与CKD患者的不良结局风险明显降低有关.
- 旨在维持更高的二碳酸盐水平的策略可能会对CKD进展产生保护作用.
- 需要进一步进行高质量的随机对照试验,以证实这些发现,并为二碳酸盐补充剂的临床建议提供指导.
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