麻症及其个体特征独立预测透析患者的死亡率:系统性审查和元分析
Alice Sabatino1, Alessandro Guerra2, Kenia Mara Baiocchi de Carvalho3
1Division of Renal Medicine, Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Journal of cachexia, sarcopenia and muscle
|October 10, 2025
概括
标志着肌肉质量和强度较低的萨尔科佩尼亚,显著增加了透析患者的死亡风险. 仅仅低肌肉强度也会增加死亡风险,远远高于仅仅低肌肉质量.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 老年病的医生 老年病的医生
- 肌肉骨健康 肌肉骨健康
背景情况:
- 透析患者经常经历肌肉衰竭和肌肉衰弱,影响生存.
- 这些情况可能会对患者的治疗结果和生存率产生负面影响.
研究的目的:
- 系统地审查和元分析透析患者的死亡风险和特定肌肉疾病之间的关联.
- 为了比较低肌肉质量与足够强度的关联强度,低强度与足够质量的关联强度,以及与死亡率的sarcopenia.
主要方法:
- 在多个数据库 (MEDLINE,Embase,Web of Science,Lilacs) 和灰色文献中进行系统搜索,直到2024年1月.
- 包括对成人透析患者的研究,其死亡随访时间≥12个月.
- 随机效应元分析以估计死亡风险的危险比率 (HR) 和95%置信区间 (CI).
主要成果:
- 19项研究 (4281名参与者) 纳入了定性综合;17项研究 (4024名参与者) 纳入了元分析.
- 具有足够强度的低肌肉质量:HR 1.49 (95% CI 1.04-2.13).
- 低肌肉力量与足够的质量:HR 1.82 (95% CI 1.38-2.41).
- 萨尔科佩尼亚 (低质量和强度):HR 2.02 (95% CI 1.61-2.54).
结论:
- 低肌肉强度和肉显著与透析患者的死亡率增加有关.
- 在评估的肌肉疾病中,sarcopenia具有最高的过早死亡风险.
- 仅仅较低的肌肉质量似乎与较低的肌肉力量相比,与死亡率的相关性不那么明显.
相关概念视频
01:28Chronic Kidney Disease III: Interprofessional Care
339
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
339
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
234
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
234
01:29Bone Disorders
5.1K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
5.1K
01:27Dialysis
1.2K
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...
1.2K
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
189
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
189
01:24Chronic Kidney Disease II: Clinical Manifestations
552
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
552