估计的GFR斜率与老年人心力衰竭进展的关联
Karim Kohansal1, Amir Abdi1, Davood Khalili1
1Prevention of Metabolic Disorders Research Center, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
概括
通过估计的膜过率 (eGFR) 斜率来衡量功能更快下降,与心脏异常的老年人心力衰竭 (HF) 风险增加有关. 这一发现可能有助于识别高风险患HF的个体,特别是具有保留喷射分数 (HFpEF) 的HF.
科学领域:
- 腎病學和心臟病學.
- 老年医学 老年医学
- 流行病学 流行病学
背景情况:
- 心力衰竭 (HF) 是老年人群的重大健康问题.
- 功能下降之间的关系,特别是估计的膜过率 (eGFR) 斜率,和HF发病率需要进一步调查.
- 识别高风险的人群对于及时干预至关重要.
研究的目的:
- 调查eGFR斜率与老年人中发生的HF事件之间的关联.
- 要在两个HF前组中检查这种关联:风险较高的人 (A阶段) 和心脏异常的人 (B阶段).
主要方法:
- 一项前性队列研究,涉及5362名来自社区动脉样硬化风险研究的参与者.
- 使用从eGFR测量的线性混合效应模型估计了eGFR斜率.
- 使用住院ICD-9/10代码识别了HF事件;用于分析,采用了特定原因的危险模型.
主要成果:
- 在A阶段的参与者中,没有发现eGFR斜率和高频率之间的显著关联.
- 在B阶段的参与者中,更的eGFR斜率 (下降>1.87mL/min/1.73m2/year) 与增加的HF风险 (HR,1.58) 和具有保留射出分数 (HFpEF) 的HF显著相关 (HR,1.54).
- 在B阶段的相关性是非线性的,当eGFR斜率大于-1.25mL/min/1.73m2/year时,没有检测到高高频风险.
结论:
- eGFR斜率可以作为一种有价值的指标,用于识别患有高风险的老年人,特别是高风险的老年人.
- 虽然eGFR斜率有希望,但由于潜在的波动模式,它可能无法完全捕捉功能下降的复杂性.
- 追踪eGFR斜率变化提供了一个潜在的风险分层策略,在HF前的人口.
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