预先存在的心血管疾病,高血压和腹腔透析中的死亡率
Juan Wu1, Xiaojiang Zhan2, Yueqiang Wen3
1Urology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), 310014 Hangzhou, Zhejiang, China.
Reviews in cardiovascular medicine
|July 30, 2024
概括
以前存在的心血管疾病 (CVD) 和高血压显著增加腹腔透析 (PD) 患者的死亡风险. 这两种情况的结合构成最高的死亡风险,突出显示了它们的附加预后影响.
科学领域:
- 脏病学和心血管医学.
- 流行病学和公共卫生.
背景情况:
- 心血管疾病 (CVD) 和高血压是周周透析 (PD) 患者不良结果的已知风险因素.
- 预先存在的心血管疾病和高血压对PD患者的综合预后影响需要进一步全面评估.
研究的目的:
- 调查先前存在的心血管疾病 (CVD),高血压和发生腹腔透析 (PD) 患者的死亡率之间的联合关联.
- 确定心血管疾病和高血压对PD所有原因和心血管疾病特异性死亡率的独立和综合预后意义.
主要方法:
- 这是一项追溯性队列研究,涉及来自中国五个透析中心的3073名PD患者 (2005-2018).
- 考克斯回归模型和细灰竞争风险模型用于分析先前存在的心血管疾病,高血压和死亡结果之间的关联.
- 根据相关的混因素进行了调整,以隔离心血管疾病和高血压的影响.
主要成果:
- 在33.7个月的中位数随访期间,18.6%的患者死亡,其中9.3%是由于心血管疾病.
- 与对照组相比,患有先前存在的心血管疾病和高血压的患者的全因死亡率 (HR:3.97) 和心血管疾病死亡率 (HR:4.68) 的风险最高.
- 单独来看,先前存在的心血管疾病 (HR:所有原因死亡率为2.21) 和高血压 (HR:所有原因死亡率为1.83) 也显著增加了死亡风险.
结论:
- 以前存在的心血管疾病和高血压对PD患者的死亡率具有附加的预后价值.
- 预先存在的心血管疾病在这种PD人群中与死亡风险的关联比高血压更强.
- 这些发现强调了在PD患者中管理心血管风险因素的重要性,以改善生存结果.
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