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Clinica Chimica Acta：在慢性肾脏疾病患者中，红细胞大小的变化可以预测所有原因的死亡，但不能预测透析的进展？

2019-11-23 MedSci MedSci原创

慢性肾脏疾病
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红细胞分布宽度(RDW)对慢性肾脏疾病(CKD)患者的预后作用尚不清楚。考虑到RDW的基线值和纵向轨迹以及平均微粒体积(MCV)，很少有证据能提供全面的预测分析。

红细胞分布宽度(RDW)对慢性肾脏疾病(CKD)患者的预后作用尚不清楚。考虑到RDW的基线值和纵向轨迹以及平均微粒体积(MCV)，很少有证据能提供全面的预测分析。

研究人员对2003年至2015年间接受多学科护理的4621例CKD（年龄在20-90岁之间）的登记患者进行了RDW和MCV的综合风险评估。RDW和MCV的基线和纵向轨迹均被建模为预测因子 通过使用多个Cox比例风险回归模型（包括时变协变量和对命令性混杂变量的调整）来评估终末期肾病（ESRD）和死亡率。

研究结果显示，完全校正的危险比(HR;RDW和MCV在基线每增加一个单位，ESRD进展的95% CI分别为0.97(0.93-1.02)和1.00(0.99-1.01)。纵向上，RDW和MCV轨迹均与ESRD的进展无关。对于全因死亡率，RDW呈线性剂量-反应关系，每增加一个百分点，完全校正HRs (95%CI)为1.09 (1.04-1.14)，RDW轨道与正常RDW轨道相比稳定高RDW轨道为1.95(1.47-2.59)。RDW对伴有高MCV状态的患者死亡率的影响进一步增强。将即时RDW大大提高了歧视性能量化使用哈勒尔C统计到现有的慢性肾病死亡率预测方程(从0.770到0.784,P = .018)。

研究结果支持RDW在预测CKD患者全因死亡中的临床应用。本研究发现的机制对CKD风险评估和管理至关重要，尤其是从营养不良、炎症和动脉粥样硬化的角度。

原始出处：

Hung-Chieh Yeh，Yu-Ting Lin，Variability of red blood cell size predicts all-cause mortality, but not progression to dialysis, in patients with chronic kidney disease: A 13-year pre-ESRD registry-based cohort

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    2020-07-20 windight

    #CTA#

    0

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    2020-10-20 hmwwww

    #疾病患者#

    0

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    2019-11-25 kord1982

    #红细胞#

    0

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    2019-11-25 12498b08m96暂无昵称

    #慢性肾脏#

    0

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    2019-11-23 14794e5bm67(暂无昵称)

    非常好的研究，受益良多

    0

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