年轻成年人的全人口eGFR百分位数和临床结果
Junayd Hussain1,2,3, Haris Imsirovic1, Robert Talarico1
1School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
概括
在65岁以下的成年人中确定较低的估计膜过率 (eGFR) 百分点对于早期干预至关重要. 降低EGFR与不良结果,特别是功能衰竭有关,并且可能在年轻人中未被充分认识到.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 公共卫生 公共卫生
- 老年学是指老年学的学科.
背景情况:
- 在65岁以下的成年人中识别显著的估计球过率 (eGFR) 降低对于有针对性的预防策略至关重要.
- 根据年龄,人口层面的eGFR分布尚未很好地确立,以确定有风险的年轻成年人.
研究的目的:
- 检查人口层面的eGFR百分位相对于特定年龄的中位数和18-65岁成年人的临床结果之间的关联.
- 确定年轻人中较低的eGFR百分位是否与不良健康事件和医疗保健资源未充分利用有关.
主要方法:
- 对加拿大安大略省870万成年人的回顾性队列研究 (2008-2021年).
- 使用时间到事件模型计算特定年龄的EGFR中位数和分析较低EGFR百分位数 (≤10th,5th,2.5th,1st) 与复合结果 (死亡率,MACE,功能衰竭) 的关联.
- 评估医疗保健利用率 (专家转诊,重复eGFR,ACR测试) 与eGFR百分点相关.
主要成果:
- 在所有百分点中,EGFR的中位数随着年龄的增长而下降 (例如,第一百分点的EGFR在18岁时从83到65岁时从54不等).
- 对复合不良结局的调整率在≤10百分位数 (HR 1.14) 观察到较高,并且主要用于功能衰竭 (HR 5.57).
- 具有较低EGFR百分位数的年轻人不太可能获得专家推或重复EGFR/ACR测试.
结论:
- 基于人口分布的eGFR值在第10百分位或以下,与不良的临床结果有关.
- 在年轻的成年人 (18-39岁) 中,这些较低的eGFR百分位可能代表更高的eGFR值,但往往被忽视.
- 使用基于人口的eGFR百分位数可以改善对处于风险的年轻成年人的解释和识别.
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