肌肉质量和功能的变化与接受腹腔透析的个体的死亡率之间的关联
Lailiang Wang1, Congping Xue1, Beixia Zhu1
1Department of Nephrology, Ningbo No. 2 Hospital, Ningbo, China.
概括
动态肌肉质量和功能的下降显著增加了终期病 (ESKD) 患者的死亡风险,这些患者接受持续的门诊腹膜透析 (CAPD). 早期干预对于改善这一脆弱群体的生存率至关重要.
科学领域:
- 腎病學和老年醫學.
- 肌肉生理学和肌肉衰老
- 慢性疾病的临床结果.
背景情况:
- 关于肌肉质量和功能的动态变化如何影响透析患者末期病 (ESKD) 患者的死亡率,目前有不确定的数据.
- 了解这些动态对于改善患者的治疗结果和制定有针对性的干预措施至关重要.
研究的目的:
- 调查肌肉质量和功能的动态恶化与ESKD患者的全因死亡率之间的关联,这些患者接受持续的门诊腹膜透析 (CAPD).
- 确定与死亡风险增加相关的肌肉衰退的特定模式.
主要方法:
- 对217名ESKD患者进行了前性队列研究,对CAPD进行了2年的跟踪.
- 肌肉质量和功能恶化在12个月内使用2019年亚洲肉症工作组 (AWGS 2019) 标准进行评估.
- 全因死亡率作为主要结果,使用卡普兰-梅尔和考克斯比例危险模型进行分析.
主要成果:
- 动态肌肉恶化的患病率为42.9%,其中24.9%的肌肉恶化进展为肉症,18.0%的肌肉恶化进展为严重肉症.
- 与没有 (23.4%) 患者相比,肌肉恶化患者的死亡率明显高 (50.5%).
- 动态肌肉恶化独立地与所有原因死亡风险增加2.40倍相关 (p=0.001),符合灵敏度分析.
结论:
- 肌肉质量和功能的动态恶化是CAPDESKD患者死亡率增加的重要预测因素.
- 建议针对肌肉健康的个性化生活方式干预措施,以减轻整个医疗保健领域的死亡风险.
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