肥胖测量方法估计血液透析患者的死亡风险:系统性审查和元分析
Henni Kusuma1,2, Huan-Fang Lee3, Miaofen Yen1
1Department of Nursing, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan City, 701401, Taiwan.
International urology and nephrology
|December 11, 2024
概括
肥胖测量方法对血液透析患者的死亡风险产生影响. 体重指数 (BMI) 显示风险较低,而腰围和生物电阻分析显示风险较高,突出显示测量变化.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 由于各种测量方法的数据相互矛盾,肥胖对血液透析 (HD) 患者的死亡率的影响尚不清楚.
- 了解这些差异对于准确评估HD群体的风险至关重要.
研究的目的:
- 评估不同肥胖测量如何影响成年血液透析患者的死亡风险.
- 综合现有关于肥胖指标与疾病重症患者死亡率之间的关联的证据.
主要方法:
- 一个系统的审查和元分析,遵循PRISMA指南.
- 包括到2023年3月27日出版的成人疾病疾病患者的观察性研究,来源于EMBASE,MEDLINE和CINAHL.
- 使用RevMan 5.4.4进行的随机效应模型元分析.
主要成果:
- 对23项研究 (381580名受试者) 的分析显示,基于肥胖度的测量,死亡风险有所不同.
- 体重指数 (BMI) 表示死亡风险较低 (RR=0.73),而腰围 (WC) 和腰比 (WHR) 表示死亡风险增加 (RR=1.35).
- 生物电阻分析 (BIA) 也显示肥胖患者的死亡风险增加 (RR=1.22).
结论:
- 肥胖血液透析患者的死亡风险因使用的肥胖度测量方法而异.
- 与BMI观察到的"肥胖悖论"可能源于它无法有效区分脂肪质量.
- 为了解决这些相互矛盾的发现,需要使用多种类型的人类测量和身体成分分析进行进一步的研究.
相关概念视频
Dialysis
264
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
264
Factors Affecting Renal Clearance: Renal Impairment
53
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
53
Obesity
374
The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...
374
Renal Failure: Dose Adjustments
63
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
63
Hazard Ratio
90
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial...
For example, in a clinical trial...
90
Kaplan-Meier Approach
98
The Kaplan-Meier estimator is a non-parametric method used to estimate the survival function from time-to-event data. In medical research, it is frequently employed to measure the proportion of patients surviving for a certain period after treatment. This estimator is fundamental in analyzing time-to-event data, making it indispensable in clinical trials, epidemiological studies, and reliability engineering. By estimating survival probabilities, researchers can evaluate treatment effectiveness,...
98


