在接受维持血液透析的患者中,透析间血压变化和全因死亡率:使用DialysisNet的多中心研究
Eunmi Jo1, Ji Eun Kim2, Ji In Park3
1Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Clinical and experimental nephrology
|April 23, 2025
概括
血液透析期间高血压变化 (BPV) 与死亡率增加有关. 这种关联对于静脉压 (SBP) 变化特别强烈,突出了对透析患者BPV监测的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心血管医学 心血管医学
- 临床流行病学 临床流行病学
背景情况:
- 血液透析患者面临高死亡风险.
- 透析间血压变化 (BPV) 是一个潜在的危险因素.
- 了解BPV的影响对于改善患者的治疗结果至关重要.
研究的目的:
- 调查透析间BPV与血液透析患者全因死亡率之间的关联.
- 为了确定静缩血压 (SBP) 或静缩血压 (DBP) 的变化是否具有更强大的影响.
主要方法:
- 从四个透析单位回顾分析了357名血液透析患者的数据.
- 透析间BPV计算为12个月的透析前BP变化系数 (CV).
- 考克斯回归分析以评估基于SBP和DBPCV三角形的死亡风险.
主要成果:
- 较高的SBP BPV (第三位) 显著增加了所有原因的死亡率 (调整后的HR,2.11).
- 较高的DBPBPV (第三位) 在单变量分析中显示死亡率增加,但在多变量分析中没有.
- 在SBP中,BPV与死亡率之间的关联比DBP更为明显.
结论:
- 透析间BPV增加是血液透析患者全因死亡率的重要预测因素.
- SBP的变化似乎是一个比DBP的变化更强大的风险因素.
- 建议对BPV进行密切监测,特别是对于老年人,女性以及透析时间较长的人.
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