AJKD:连续肾脏替代治疗的重症患者肌酐-胱抑素C比值与死亡率的关系

2020-10-25 MedSci原创 MedSci原创

在接受重症监护和CKRT治疗的患者中,较高的肌酐:胱抑素C比值与患者更高的生存率相关。

研究表明,在多种疾病状态下,较低的血清肌酐与胱抑素C比值与较低的肌肉质量和不良的临床结局之间存在关联。在接受连续肾脏替代疗法(CKRT)的急性肾损伤(AKI)患者中确定死亡危险因素可能会改善患者的预后评估。近日,肾脏病学权威杂志Am J Kidney Dis上发表了一篇研究文章,研究人员试图评估肌酐:胱抑素C比值与接受CKRT的AKI患者预后之间的关系。

这项回顾性队列研究,纳入了韩国一家三级医疗中心1588例接受重症监护和CKRT治疗的AKI患者。该研究的预测变量为CKRT开始时的基线血清肌酐:胱抑素C比值,结局指标为CKRT启动后调整了年龄和性别的90天死亡率。研究人员采用Cox比例风险模型估算肌酐:胱抑素C比值与患者结局之间的关联。

受试者平均年龄为64.7±14.5岁,其中635名患者(40.0%)为女性。肌酐:胱抑素C之比的范围为0.08-10.48。对于较高的肌酐:胱抑素C比值组,其30天和90天的死亡率明显降低。

多变量Cox比例风险回归分析显示,随着肌酐:胱抑素C比值的增加,受试者的死亡率风险逐渐降低。当使用三次样条分析法评估肌酐:胱抑素C比值时,较高的肌酐:胱抑素C比值可降低30天和90天死亡率。即使在对混杂变量进行调整后,这些关联仍然很重要。

由此可见,在接受重症监护和CKRT治疗的患者中,较高的肌酐:胱抑素C比值与患者更高的生存率相关。

原始出处:

Chan-Young Jung,et al.Creatinine–Cystatin C Ratio and Mortality in Patients Receiving Intensive Care and Continuous Kidney Replacement Therapy: A Retrospective Cohort Study.Am J Kidney Dis.2020.https://www.ajkd.org/article/S0272-6386(20)31046-5/fulltext

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    2020-10-27 俅侠
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    2020-10-25 narutohokage

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