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Am J Kidney Dis：血清磷与心血管疾病、全因死亡率或移植失败之间的风险分析！

2017-06-03 xing.T MedSci原创

血清磷CVD全因死亡率移植失败
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由此可见，血清磷水平与CVD稍有相关，但与KTRs的移植失败和总死亡率相关性更加密切。在KTRs中进行一项随机对照以评估降低血磷治疗对这些结局潜在的影响可能是很有必要的。

轻度高磷血症是心血管疾病[CVD]、肾功能损失和死亡公认的危险因素。来自于大规模多中心的肾移植接受者（KTR）队列评估血清磷水平与CVD结局、移植失败或全因死亡率之间的潜在关系的数据十分有限。

近日，肾脏病领域权威杂志Am J Kidney Dis上发表了一篇研究文章，研究人员进行了一项队列研究，即叶酸减少移植中血管结局试验（FAVORIT试验），其是一项大型、多中心、多民族的、对照临床试验提供了明确的证据，表明基于高剂量的维生素B治疗来降低血浆中同型半胱氨酸水平降低并不能减少心血管事件、移植失败或稳定KTRs的总死亡率。

在中位随访4年期间，队列中发生了436次CVD事件，移植失败238例，死亡348例。比例风险模型显示，当对治疗分组、传统的CVD危险因素、肾脏指标、肾脏移植以及使用钙调磷酸酶抑制剂、类固醇或降脂药物进行调整后，血磷水平每升高1mg/dl并不能显著增加CVD风险（风险比为1.06；95%可信区间为未0.92-1.22），但增加了移植失败（风险比为1.36；95%可信区间为1.15-1.62）和总死亡率（风险比为1.21；95%可信区间为1.04-1.40）的风险。这些相关性在没有肾脏指标的模型中有所强化：CVD（风险比为1.14；95%可信区间为1.00-1.31）、移植失败（风险比为1.72；95%可信区间为1.46-2.01）和死亡率（风险比为1.34；95%可信区间为1.15-1.54）。

由此可见，血清磷水平与CVD稍有相关，但与KTRs的移植失败和总死亡率相关性更加密切。在KTRs中进行一项随机对照以评估降低血磷治疗对这些结局潜在的影响可能是很有必要的。

原始出处：

Basma Merhi,et al. Serum Phosphorus and Risk of Cardiovascular Disease, All-Cause Mortality, or Graft Failure in Kidney Transplant Recipients: An Ancillary Study of the FAVORIT Trial Cohort. Am J Kidney Dis.2017. http://dx.doi.org/10.1053/j.ajkd.2017.04.014

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    2018-01-16 cmj8wellington

    #Dis#

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    2017-08-08 仁心济世

    #血清磷#

    0

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createdName=1e10c84am36(暂无匿称), createdTime=Sun Jun 04 08:18:30 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206163, encodeId=d00320616336, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:25:53 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206148, encodeId=ce24206148bf, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 03 23:50:11 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206105, encodeId=274420610521, content=学习一下觉得非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Jun 03 21:02:01 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-05 lvliquan

    #全因死亡率#

    0

  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 03 23:50:11 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206105, encodeId=274420610521, content=学习一下觉得非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Jun 03 21:02:01 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-05 andy2090

    #血管疾病#

    0

  5. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 03 23:50:11 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206105, encodeId=274420610521, content=学习一下觉得非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Jun 03 21:02:01 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-05 gwc389

    #kidney#

    0

  6. 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createdName=1e10c84am36(暂无匿称), createdTime=Sun Jun 04 08:18:30 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206163, encodeId=d00320616336, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:25:53 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206148, encodeId=ce24206148bf, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 03 23:50:11 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206105, encodeId=274420610521, content=学习一下觉得非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Jun 03 21:02:01 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-04 清风拂面

    谢谢分享，学习了

    0

  7. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 03 23:50:11 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206105, encodeId=274420610521, content=学习一下觉得非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Jun 03 21:02:01 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-04 1e10c84am36(暂无匿称)

    文章很好，学习受益

    0

  8. 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    2017-06-04 tanxingdoctor

    学习啦谢谢分享

    0

  9. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 03 23:50:11 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206105, encodeId=274420610521, content=学习一下觉得非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Jun 03 21:02:01 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-03 天涯183

    非常好的文章，学习了，很受益

    0

  10. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Mon Jun 05 08:06:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603048, encodeId=ad86160304863, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c36e18990621, createdName=gwc389, createdTime=Mon Jun 05 08:06:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 03 23:50:11 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206105, encodeId=274420610521, content=学习一下觉得非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Jun 03 21:02:01 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-03 虈亣靌

    学习一下觉得非常好

    0

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