在急性损伤下进行透析后的恢复动态和预后
Heng-Chih Pan1,2,3,4,5, Hsing-Yu Chen2,6, Nai-Chi Teng7
1Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
JAMA network open
|March 8, 2024
概括
基线和后急性病 (AKD) 的功能,而不是AKD的严重程度,显著影响患者的结果,包括死亡率和主要不良心脏事件 (MACE). 了解AKD后的功能对于急性损伤需要透析 (AKI-D) 患者的长期预后至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 基线功能,急性病 (AKD) 严重程度和AKD后功能之间的相互作用对患者的结果至关重要.
- 在需要透析的急性损伤 (AKI-D) 患者中,缺乏对这些因素与死亡率,主要不良心脏事件 (MACE) 和末期病 (ESKD) 的集体关联的全面了解.
研究的目的:
- 调查基线功能,AKD严重程度和AKD后功能与AKI-D患者的死亡率,MACE和ESKD的关联.
主要方法:
- 在全国范围内,基于人口的队列研究使用台湾的医疗保健数据库 (2015-2018).
- 包括6703名AKI-D患者,具有可用的AKD后功能和AKD阶段数据.
- 分析了功能参数与主要结果 (死亡率,MACE) 和次要结果 (永久性透析,再入院) 之间的关联.
主要成果:
- 在平均1.2年的随访期间,全因死亡率为28.3%,MACE发病率为11.1%,ESKD发病率为16.7%.
- 基线和AKD后的功能,但不是AKD严重程度,都与死亡率,MACE,ESKD和再录取独立相关.
- 经AKD后功能恶化显示,不良结果的风险逐渐增加.
结论:
- 超过四分之一的AKI-D患者在1.2年内死亡.
- 基线和AKD后的功能是AKI-D患者长期预后的关键预测因素.
- 进一步研究从后AKD过渡到慢性病的转变是必不可少的.
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