心血管

订阅

MedSci主页 / 所有栏目 / 心血管

JAHA：肾功能变化与全因死亡率和心血管疾病相关

2018-10-24 xing.T MedSci原创

肾功能变化全因死亡率心血管疾病相关
关注

由此可见，随着时间的推移，eGFR的下降与全因死亡率和心血管疾病的风险相关，但独立于初始eGFR和基线其它已知的危险因素。研究人员的数据支持对肾功能变化的连续评估作为比单次eGFR评估更好的预后指标。

目前对于估计的肾小球滤过率（eGFR）的连续变化与临床结局之间关系的评估仍然不一致。近日，心血管疾病领域权威杂志JAHA上发表了一篇研究文章，研究人员的目的是研究肾功能随时间的变化与全因死亡率和心血管疾病风险之间的关系。

该前瞻性队列使用了开滦卫生注册处的数据，纳入了37691名年龄超过45岁的参与者。研究人员采用Cox比例回归分析了eGFR年度百分比和绝对变化与患者结局之间的关系。参与者根据eGFR年度变化百分比（Q1-Q5）的五分位数进行分层。

在调整包括初始eGFR在内的基线协变量后，年度eGFR下降的参与者全因死亡风险显著增加（Q1：风险比为1.22 [95％置信区间为1.04-1.43]; Q2：1.19 [1.01-1.40] ）相比于Q3的患者。年度eGFR下降（Q1和Q2）的参与者的心血管疾病风险也显著升高。对于年度eGFR增加（Q4和Q5）的患者，没有显著增加不良结果的风险。当考虑到年度绝对eGFR变化率（无/轻度/快速下降）时，研究人员在慢性肾病参与者中得到了类似的结果，而非慢性肾病参与者eGFR下降与心血管疾病的关联性较小，但与死亡率无关。

由此可见，随着时间的推移，eGFR的下降与全因死亡率和心血管疾病的风险相关，但独立于初始eGFR和基线其它已知的危险因素。研究人员的数据支持对肾功能变化的连续评估作为比单次eGFR评估更好的预后指标。

原始出处：

Yidan Guo.et al. Change of Kidney Function Is Associated With All‐Cause Mortality and Cardiovascular Diseases: Results From the Kailuan Study.JAHA.2018. https://www.ahajournals.org/doi/10.1161/JAHA.118.010596

本文系梅斯医学（MedSci）原创编译整理，转载需授权！

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1850692, encodeId=681118506925b, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=10, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Fri Mar 08 15:26:00 CST 2019, time=2019-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251504, encodeId=ec151251504a2, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267950, encodeId=0d30126e95023, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498487, encodeId=cc48149848ece, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=13, 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=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350411, encodeId=5eab35041197, content=了解一下，谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Wed Oct 24 21:52:28 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2019-03-08 yese

    #肾功能#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1850692, encodeId=681118506925b, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=10, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Fri Mar 08 15:26:00 CST 2019, time=2019-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251504, encodeId=ec151251504a2, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267950, encodeId=0d30126e95023, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498487, encodeId=cc48149848ece, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=13, 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=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350411, encodeId=5eab35041197, content=了解一下，谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Wed Oct 24 21:52:28 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2018-10-26 lvliquan

    #全因死亡率#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1850692, encodeId=681118506925b, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=10, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Fri Mar 08 15:26:00 CST 2019, time=2019-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251504, encodeId=ec151251504a2, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267950, encodeId=0d30126e95023, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498487, encodeId=cc48149848ece, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=13, 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=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350411, encodeId=5eab35041197, content=了解一下，谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Wed Oct 24 21:52:28 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2018-10-26 zhaohui6731

    #AHA#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1850692, encodeId=681118506925b, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=10, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Fri Mar 08 15:26:00 CST 2019, time=2019-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251504, encodeId=ec151251504a2, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267950, encodeId=0d30126e95023, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498487, encodeId=cc48149848ece, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=13, 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=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350411, encodeId=5eab35041197, content=了解一下，谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Wed Oct 24 21:52:28 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2018-10-26 andy2090

    #血管疾病#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1850692, encodeId=681118506925b, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=10, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Fri Mar 08 15:26:00 CST 2019, time=2019-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251504, encodeId=ec151251504a2, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267950, encodeId=0d30126e95023, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498487, encodeId=cc48149848ece, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=13, 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=Fri Oct 26 12:26:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350411, encodeId=5eab35041197, content=了解一下，谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Wed Oct 24 21:52:28 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2018-10-24 天地飞扬

    了解一下，谢谢分享！

    0