日本KDIGO热图中的心血管,和死亡风险
Shoichi Maruyama1, Tetsuhiro Tanaka2, Hiroki Akiyama3
1Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Clinical kidney journal
|August 22, 2024
概括
病:改善全球结果 (KDIGO) 热图有效预测日本慢性病 (CKD) 患者的主要不良心血管事件 (MACE) 和结局. 早期的CKD检测和干预对于更好的预后至关重要.
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:
- 慢性病 (CKD) 在全球范围内构成重大健康负担.
- 预后工具对于管理CKD患者和预防不良结果至关重要.
- 病:改善全球结果 (KDIGO) 热图是CKD的风险分层工具.
研究的目的:
- 评估KDIGO热图在患有CKD的日本人群中的预后能力.
- 评估KDIGO风险类别与主要心血管不良事件 (MACE) 和结局之间的关联.
主要方法:
- 日本电子医疗记录数据库的回顾性分析.
- 包括543,606名估计膜过率 (eGFR) <90毫升/分钟/1.73米2的个体.
- 主要结局的评估:MACE (心肌梗塞,中风,心力衰竭住院,住院死亡) 和二次结局,按KDIGO热图类别分层.
主要成果:
- 在KDIGO阶段,MACE和结局的风险随着eGFR的下降和蛋白尿的增加而增加.
- 对于MACE1和MACE2的危险比率从早期阶段 (例如G3aA1,G2A2) 到高级阶段 (G5A3) 显著增加.
- 对于G5A3,MACE1的风险是2.83 (95%CI:2.54-3.15) 和MACE2的风险是3.43 (95%CI:3.00-3.93) 与G2A1.93相比.
结论:
- 这项研究证实了KDIGO热图在日本对心血管和风险评估的适用性.
- 调查结果强调,即使从CKD的早期阶段开始,风险也会升级.
- 强调早期诊断和及时干预对CKD管理的关键需求.
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