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Publication Trends and Research Hotspots of the Cardiorenal Syndrome: A Bibliometrics and Visual Analysis from 2003 to 2023. 心肾综合征的出版趋势和研究热点:2003年至2023年文献计量学和视觉分析。
IF 3.8 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-01-01 Epub Date: 2024-05-13 DOI: 10.1159/000539306
Yibo Shi, Zean Fu, Shixiong Wu, Xinyi Yu

Introduction: Cardiorenal syndrome encompasses a range of disorders involving both the heart and kidneys, wherein dysfunction in one organ may induce dysfunction in the other, either acutely or chronically.

Methods: This study conducted a literature search on cardiorenal syndrome from January 1, 2003, to September 8, 2023. Meanwhile, a quantitative analysis of the developmental trajectory, research hotspots and evolutionary trends in the field of cardiorenal syndrome through bibliometric analysis and knowledge mapping was carried out.

Results: The annual publication trend analysis revealed a consistent annual increase in cardiorenal syndrome literature over the last 20 years. The IL6, REN, and INS genes were identified as the current research hotspots.

Conclusion: The field of cardiorenal syndrome exhibits promising potential to grow and is emerging as a prominent research area. Future endeavours should prioritise a comprehensive understanding of the field and foster multi-centre co-operation among different countries and regions.

导言心肾综合征包括一系列涉及心脏和肾脏的疾病,其中一个器官的功能障碍可能会诱发另一个器官的功能障碍,无论是急性还是慢性。本研究对 2003 年 1 月 1 日至 2023 年 9 月 8 日期间有关心肾综合征的文献进行了检索。同时,通过文献计量分析和知识图谱,对心肾综合征领域的发展轨迹、研究热点和演变趋势进行了定量分析。未来的工作应优先考虑全面了解该领域,并促进不同国家和地区之间的多中心合作:年度发表趋势分析显示,在过去 20 年中,心肾综合征的文献每年都在持续增加。IL6、REN和INS基因被确定为当前的研究热点。
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引用次数: 0
Outcomes of Patients with Critical Limb Ischemia and Chronic Kidney Disease: A National Perspective. 重症肢体缺血合并慢性肾病患者的治疗效果:全国视角。
IF 2.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-01-01 Epub Date: 2024-09-02 DOI: 10.1159/000541146
Frederick Berro Rivera, John Paul Aparece, Jade Monica Marie Ruyeras, Rajiv Hans Menghrajani, Mc John Ybañez, Emily Grace Candida Honorio, Jeffrae Isaac Albert Ramirez Damayo, Guowei Li, Alok Dwivedi, Rachel Anne Puentespina, Pauline Julia Talili, Joanna Pauline Cu, Josiah Juan Alfonso Marañon Joson, Nathan Ross Baoy Bantayan, Edgar V Lerma, Fareed Moses Collado, Kenneth Ong, Krishnaswami Vijayaraghavan, Amir Kazory

Introduction: Studies exploring the relationship between peripheral arterial disease (PAD), critical limb ischemia (CLI), and chronic kidney disease (CKD) and its effect on in-hospital outcomes are limited. We aimed to analyze the outcomes of patients with CKD and PAD who are admitted for CLI.

Methods: We utilized the National Inpatient Sample (NIS) to capture hospitalizations for CLI from 2012 to 2020 and then identified cases with concomitant CKD. The primary outcome was mortality, and secondary outcomes were cerebrovascular accident, major bleeding, vasopressor requirement, percutaneous coronary intervention, cardiac arrest, acute respiratory failure, transfusion, length of stay, and total hospital charges. Multivariable logistic regression was performed to adjust for covariates.

Results: A total of 441,245 patients with CLI were identified, of which 122,370 (27.7%) reported concomitant CKD. Patients with CKD had higher in-patient mortality (odds ratio [OR] 1.68, 95% confidence interval [CI], 1.17-1.68, p < 0.001), vascular complications (OR 1.31, 95% CI, 1.17-1.48, p < 0.001), acute kidney injury requiring hemodialysis (OR 3.17, 95% CI, 2.64-3.80, p < 0.001), and major bleeding (OR 1.12, 95% CI, 1.05-1.19, p < 0.001). Patients with CKD underwent minimally invasive endovascular therapy (31.08% vs. 36.73%, p < 0.0001) and invasive procedures (14.73% vs. 23.55%, p < 0.0001) less often. PAD-CLI with CKD was associated with major (20.54% vs. 16.17%, OR 1.04; p < 0.0001) and minor (26.87% vs. 19.53%, OR 1.2, p < 0.0001) amputations more often.

Conclusion: Patients admitted for PAD-CLI with concomitant CKD have significantly higher in-hospital mortality as compared to patients without CKD. Moreover, patients with CKD and PAD-CLI are less likely to receive revascularization and more likely to undergo amputation.

导言:探索外周动脉疾病(PAD)、危重肢体缺血(CLI)和慢性肾脏疾病(CKD)之间的关系及其对院内预后影响的研究非常有限。我们的目的是分析因肢体缺血而入院的患有慢性肾脏病和 PAD 的患者的预后:我们利用全国住院病人抽样调查(NIS)收集了 2012-2020 年间因 CLI 住院的病例,然后确定了合并 CKD 的病例。主要结果是死亡率,次要结果是脑血管意外、大出血、血管舒张剂需求、经皮冠状动脉介入治疗、心脏骤停、急性呼吸衰竭、输血、住院时间(LOS)和住院总费用。采用多变量逻辑回归调整协变量:共发现 441,245 名 CLI 患者,其中 122,370 人(27.7%)报告同时患有慢性肾脏病。慢性肾脏病患者的住院死亡率(OR 1.68,CI,1.17-1.68,p<0.001)、血管并发症(OR 1.31,95% CI,1.17-1.48,p<0.001)、需要血液透析的急性肾损伤(OR 3.17,95% CI,2.64-3.80,p<0.001)和大出血(OR 1.12,95% CI 1.05-1.19,p<0.001)均较高。CKD患者接受微创血管内治疗(31.08% vs 36.73%,p<0.0001)和有创手术(14.73% vs 23.55%,p<0.0001)的比例较低。伴有慢性肾脏病的PAD-CLI患者更常发生大截肢(20.54% vs. 16.17%,OR 1.04;p<0.0001)和小截肢(26.87% vs. 19.53%,OR 1.2,p<0.0001):结论:与无慢性肾脏病的患者相比,因PAD-CLI入院并伴有慢性肾脏病的患者院内死亡率明显更高。此外,伴有 CKD 和 PAD-CLI 的患者接受血管重建的可能性更小,而截肢的可能性更大。
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引用次数: 0
Usefulness of Antigen Carbohydrate 125 and N-Terminal Pro-B-Type Natriuretic Peptide for Assessing Congestion in Chronic Heart Failure: Insights from the CARDIOREN Registry. 抗原碳水化合物 125 和 N 端前 b 型钠利尿肽对评估慢性心力衰竭患者充血状况的作用:来自 CARDIOREN 登记的启示。
IF 2.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-01-01 Epub Date: 2024-09-05 DOI: 10.1159/000541324
Jara Gayán Ordás, Julio Nuñez, Ramón Bascompte Claret, Pau Llacer, Isabel Zegri-Reiriz, Rafael de la Espriella, Aleix Fort, Jorge Rubio-Gracia, Zorba Blazquez-Bermejo, Ana Mendez, Inés Ponz, Adriana Rodriguez Chaverri, Pedro Caravaca-Pérez, Alejandro Recio Mayoral, Clara Jiménez Rubio, Antonia Pomares, María José Soler, Paula Fluviá, Belén García Magallón, José Luis Górriz, Luis Manzano, Faeq Husain-Syed, Marta Cobo Marcos

Introduction: A comprehensive assessment of congestion, including circulating biomarkers, is recommended in patients with acute heart failure. The circulating biomarkers natriuretic peptides (NPs) and carbohydrate antigen-125 (CA125) could be useful for congestion assessment in ambulatory chronic heart failure (CHF), but there is only limited information about their applicability in this context. Therefore, this study aimed to examine the association of plasma CA125 and NP levels with clinical and ultrasound congestion parameters in CHF.

Methods: This is a cross-sectional substudy of the Cardioren Spanish Registry, which enrolled 1,107 patients with CHF from 13 tertiary hospitals in Spain between October 2021 and February 2022. Through ambulatory visits, we performed a comprehensive assessment of congestion-related parameters, including clinical variables (orthopnea, peripheral edema, and jugular engorgement, represented by the composite congestion score [CCS]), echocardiography variables (lung B-lines and inferior vena cava [IVC] diameter), and circulating biomarkers (CA125 and NPs). The association of the NP and CA125 levels with the clinical and echocardiographic congestion parameters was examined by multiple linear and logistic regression analyses.

Results: This substudy included 802 patients for whom all the biomarker parameters were available {median age, 74 (interquartile range [IQR], 63-81) years; 65% male}. The proportion of patients with left ventricular ejection fraction ≥50% and estimated glomerular filtration rate <60 was 34% and 58%, respectively. The median CCS was 0 (IQR: 0-1), with 45% of the sample exhibiting a median CCS of ≥1. The jugular engorgement, peripheral edema, and orthopnea rates were 32%, 21%, and 21%, respectively. A total of 35% of patients who underwent ultrasound examination showed lung B-lines, and the median IVC diameter was 16 mm. The median CA125 and NTproBNP levels were 14 U/mL (IQR: 9-28) and 1,382 pg/mL (IQR: 563-3,219), respectively. Multivariate analysis showed that higher CA125 levels were independently associated with higher odds of peripheral edema (p = 0.023) and lung B-lines (p < 0.001). Further, NTproBNP was positively associated with jugular engorgement (p < 0.001), orthopnea (p = 0.034), and enlarged IVC diameter (p = 0.031).

Conclusions: Clinical signs of congestion are frequent in CHF. In the ambulatory setting, NTproBNP was associated with parameters linked to intravascular congestion such as orthopnea, jugular engorgement, and IVC diameter, whereas CA125 was associated with extravascular volume overload parameters (peripheral edema and lung B-lines).

导言和目的:建议对急性心力衰竭患者进行包括循环生物标志物在内的充血综合评估。循环生物标志物钠尿肽(NPs)和碳水化合物抗原-125(CA125)可用于流动性慢性心力衰竭(CHF)的充血评估,但关于它们在这种情况下的适用性的信息非常有限。因此,本研究旨在探讨血浆 CA125 和 NP 水平与 CHF 临床和超声充血参数之间的关联:本研究是西班牙 Cardioren 登记处的一项横断面子研究,该登记处在 2021 年 10 月至 2022 年 2 月期间从西班牙 13 家三级医院招募了 1107 名 CHF 患者。通过门诊访问,我们对充血相关参数进行了全面评估,包括临床变量(呼吸暂停、外周水肿和颈静脉充血,以综合充血评分 [CCS] 表示)、超声心动图变量(肺 B 线和下腔静脉 [IVC] 直径)以及循环生物标志物(CA125 和 NPs)。NP和CA125水平与临床和超声心动图充血参数的关系通过多元线性和逻辑回归分析进行了检验:这项子研究共纳入了 802 名具备所有生物标记物参数的患者(中位年龄 74 [IQR, 63-81] 岁;65% 为男性)。左心室射血分数 50% 和估计肾小球滤过率 <60 的患者比例分别为 34% 和 58%。CCS中位数为0(四分位数间距[IQR]:0-1),45%的样本CCS中位数≥1。颈静脉充盈、外周水肿和呼吸困难发生率分别为32%、21%和21%。接受超声波检查的患者中,共有 35% 显示肺 B 线,中位 IVC 直径为 16 毫米。CA125 和 NTproBNP 水平的中位数分别为 14 U/mL(IQR:9-28)和 1382 pg/mL(IQR:563-3219)。多变量分析显示,较高的 CA125 水平与较高的外周水肿(p = 0.023)和肺 B 线(p < 0.001)几率独立相关。此外,NTproBNP 与颈静脉充盈(p < 0.001)、呼吸暂停(p = 0.034)和 IVC 直径增大(p = 0.031)呈正相关:结论:慢性心力衰竭患者常有充血的临床表现。在门诊环境中,NTproBNP 与血管内充血相关的参数(如呼吸暂停、颈静脉充盈和 IVC 直径)有关,而 CA125 则与血管外容量超负荷参数(外周水肿和肺 B 线)有关。.
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引用次数: 0
Recurrent Hospitalizations for Fluid Overload in Diabetes with Kidney Failure Treated with Dialysis. 接受透析治疗的肾衰竭糖尿病患者因体液超负荷而反复住院。
IF 2.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-01-01 Epub Date: 2024-11-07 DOI: 10.1159/000542446
Chee Chin Phang, Li Choo Ng, Hanis Abdul Kadir, Peiyun Liu, Sheryl Gan, Lina HuiLin Choong, Chieh Suai Tan, Yong Mong Bee, Cynthia Lim

Introduction: Diabetes mellitus is the most common cause of end-stage kidney disease (ESKD) in Singapore. ESKD patients have high disease burden and are at increased risk of recurrent hospitalizations, including fluid overload. This study aimed to characterize the risk factors associated with readmissions for fluid overload that will identify high-risk hospitalizations for interventions to reduce readmissions.

Methods: Retrospective cohort study of all hospitalizations for fluid overload in adults with diabetes and ESKD on dialysis in SingHealth hospitals between 2018 and 2021. Fluid overload was defined by discharge codes for fluid overload, heart failure, pulmonary edema, and generalized edema. Multivariable Cox regression analysis using the Prentice, Williams and Peterson Total Time model was performed for the outcomes of readmissions for fluid overload within 30 days and 90 days of discharge.

Results: Among 3,234 hospitalizations for fluid overload, readmission for fluid overload within 30 days and 90 days occurred in 585 (18.1%) and 967 (29.9%) hospitalizations, respectively. Ischemic heart disease, peripheral vascular disease, and lower hemoglobin level were independently associated with readmissions for fluid overload within 30 and 90 days. Additionally, heart failure, hemodialysis (compared to peritoneal dialysis), and lack of statin at discharge were associated with increased 90-day readmission risk.

Conclusion: Modifiable (hemoglobin level, statin use) and non-modifiable factors (ischemic heart disease, peripheral vascular disease, and heart failure) influenced the risk of readmission for fluid overload. These results may guide risk stratification and inform targeted interventions to reduce avoidable, unplanned readmissions for recurrent fluid overload among individuals with diabetes and ESKD.

背景& 目的 糖尿病是新加坡终末期肾病(ESKD)最常见的病因。终末期肾病患者的疾病负担较重,反复住院的风险也较高,其中包括液体超负荷。本研究旨在分析与液体超负荷再入院相关的风险因素,从而确定高风险住院患者,以便采取干预措施减少再入院。方法 对2018年至2021年期间新加坡保健集团(SingHealth)医院中所有因液体超负荷而住院的成人糖尿病和ESKD透析患者进行回顾性队列研究。截至 2022 年 12 月 30 日,液体超负荷的定义是液体超负荷、心力衰竭、肺水肿和全身水肿的出院代码。使用普伦蒂斯、威廉姆斯和彼得森总时间(PWP-TT)模型对出院后30天和90天内因体液超负荷再入院的结果进行了多变量Cox回归分析。结果 在 3234 例因体液超负荷而住院的患者中,分别有 585 例(18.1%)和 967 例(29.9%)在出院 30 天和 90 天内因体液超负荷而再次入院。缺血性心脏病、外周血管疾病和较低的血红蛋白水平与 30 天和 90 天内因体液超负荷再入院有独立关联。此外,心力衰竭、血液透析(与腹膜透析相比)和出院时未服用他汀类药物与 90 天内再入院风险增加有关。结论 可改变因素(血红蛋白水平、他汀类药物的使用)和不可改变因素(缺血性心脏病、外周血管疾病和心力衰竭)会影响体液超负荷再入院的风险。这些结果可为风险分层提供指导,并为有针对性的干预措施提供信息,以减少糖尿病合并 ESKD 患者因复发性体液过多而再次入院的可避免的非计划入院情况。
{"title":"Recurrent Hospitalizations for Fluid Overload in Diabetes with Kidney Failure Treated with Dialysis.","authors":"Chee Chin Phang, Li Choo Ng, Hanis Abdul Kadir, Peiyun Liu, Sheryl Gan, Lina HuiLin Choong, Chieh Suai Tan, Yong Mong Bee, Cynthia Lim","doi":"10.1159/000542446","DOIUrl":"10.1159/000542446","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes mellitus is the most common cause of end-stage kidney disease (ESKD) in Singapore. ESKD patients have high disease burden and are at increased risk of recurrent hospitalizations, including fluid overload. This study aimed to characterize the risk factors associated with readmissions for fluid overload that will identify high-risk hospitalizations for interventions to reduce readmissions.</p><p><strong>Methods: </strong>Retrospective cohort study of all hospitalizations for fluid overload in adults with diabetes and ESKD on dialysis in SingHealth hospitals between 2018 and 2021. Fluid overload was defined by discharge codes for fluid overload, heart failure, pulmonary edema, and generalized edema. Multivariable Cox regression analysis using the Prentice, Williams and Peterson Total Time model was performed for the outcomes of readmissions for fluid overload within 30 days and 90 days of discharge.</p><p><strong>Results: </strong>Among 3,234 hospitalizations for fluid overload, readmission for fluid overload within 30 days and 90 days occurred in 585 (18.1%) and 967 (29.9%) hospitalizations, respectively. Ischemic heart disease, peripheral vascular disease, and lower hemoglobin level were independently associated with readmissions for fluid overload within 30 and 90 days. Additionally, heart failure, hemodialysis (compared to peritoneal dialysis), and lack of statin at discharge were associated with increased 90-day readmission risk.</p><p><strong>Conclusion: </strong>Modifiable (hemoglobin level, statin use) and non-modifiable factors (ischemic heart disease, peripheral vascular disease, and heart failure) influenced the risk of readmission for fluid overload. These results may guide risk stratification and inform targeted interventions to reduce avoidable, unplanned readmissions for recurrent fluid overload among individuals with diabetes and ESKD.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"612-623"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
QTc Interval Prolongation Is Independently Associated with FGF23 and Predicts Mortality in Predialysis Chronic Kidney Disease. QTc间期延长与FGF23独立相关,并预测透析前CKD的死亡率。
IF 3.8 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI: 10.1159/000535133
Tabo Sikaneta, Natalie Ho, Antonio Bellasi, Sara Mahdavi, Hulya Taskapan, Anton Svendrovski, Bhavanesh Makanjee, Jason Roberts, George Wu, Bharat Nathoo, Paul Tam

Introduction: QTc interval prolongation is increasingly frequent as chronic kidney disease (CKD) advances and predicts death in dialysis. However, predictors and mortality risk in predialysis CKD are understudied. FGF23 induces left ventricular hypertrophy (LVH) which is associated with QTc interval prolongation and death, suggesting a possible pathway from FGF23 to death that entails LVH and QTc prolongation. We looked for links between FGF23 and prolonged QTc intervals mediated by LVH and for deaths associated with QTc prolongation in a prospective observational cohort of patients with predialysis CKD.

Methods: Participants underwent protocolized baseline and semiannual FGF23 testing, baseline and study end echocardiograms, and baseline and annual electrocardiograms over 3 years.

Results: A total of 2,254 participants (34.1% female; mean age: 68.7 years; mean glomerular filtration: rate 41.4 mL/min/m2) enrolled in the study. Baseline LVH (left ventricular mass index >131 g/m2 [>100 g/m2 if female]) was present in 10.8% and prolonged QTc intervals (≥500 ms) in 1.5% of participants. One hundred thirty-eight (6.1%) participants died during the study. In generalized mixed-effects regression, each unit increase in the natural log of FGF23 - but not LVH - predicted an odds ratio of 1.76 (1.15, 2.70, p = 0.009) for prolonged QTc intervals independently of 15 other covariates. Mediation analysis showed that only 13% of FGF23's total effect on prolonged QTc intervals was mediated by LVH. Patients with prolonged QTc intervals had higher unadjusted (log rank p < 0.001) and adjusted (hazard ratio: 2.06 [1.08, 3.92, p = 0.028]) mortality rates than those with QTc intervals <500 ms.

Discussion: QTc interval prolongation ≥500 ms was prospectively associated with FGF23 independently of LVH and with increased mortality risk in patients with predialysis CKD.

导读:随着CKD的进展,QTc间期延长越来越频繁,并预示着透析患者的死亡。然而,透析前CKD的预测因素和死亡风险尚未得到充分研究。FGF23诱导左心室肥厚(LVH), LVH与QTc间期延长和死亡相关,提示FGF23致死亡可能存在LVH和QTc延长的途径。我们在透析前CKD患者的前瞻性观察队列中寻找FGF23与LVH介导的QTc间隔延长之间的联系,以及与QTc延长相关的死亡。方法:参与者接受了协议化的基线和半年一次的FGF23测试,基线和研究结束时的超声心动图,以及三年的基线和年度心电图。结果:2254名参与者(女性34.1%;平均年龄68.7岁;平均肾小球滤过率41.4 ml/min/m2)。基线LVH(左室质量指数>131 g/m2(女性>100 g/m2))存在10.8%,QTc间隔延长(>=500 ms)存在1.5%。138名(6.1%)参与者在研究期间死亡。在广义混合效应回归中,独立于其他15个协变量,延长QTc间隔,FGF23自然对数每增加一个单位(LVH不增加)的比值比为1.76 (1.15,2.70,p=0.009)。中介分析显示,只有13%的FGF23对延长QTc间隔的总效应是由LVH介导的。QTc间期延长的患者具有更高的未调整(log rank) p。结论:QTc间期延长≥500 ms与FGF23独立于LVH相关,并且与透析前CKD患者的死亡风险增加三倍相关。
{"title":"QTc Interval Prolongation Is Independently Associated with FGF23 and Predicts Mortality in Predialysis Chronic Kidney Disease.","authors":"Tabo Sikaneta, Natalie Ho, Antonio Bellasi, Sara Mahdavi, Hulya Taskapan, Anton Svendrovski, Bhavanesh Makanjee, Jason Roberts, George Wu, Bharat Nathoo, Paul Tam","doi":"10.1159/000535133","DOIUrl":"10.1159/000535133","url":null,"abstract":"<p><strong>Introduction: </strong>QTc interval prolongation is increasingly frequent as chronic kidney disease (CKD) advances and predicts death in dialysis. However, predictors and mortality risk in predialysis CKD are understudied. FGF23 induces left ventricular hypertrophy (LVH) which is associated with QTc interval prolongation and death, suggesting a possible pathway from FGF23 to death that entails LVH and QTc prolongation. We looked for links between FGF23 and prolonged QTc intervals mediated by LVH and for deaths associated with QTc prolongation in a prospective observational cohort of patients with predialysis CKD.</p><p><strong>Methods: </strong>Participants underwent protocolized baseline and semiannual FGF23 testing, baseline and study end echocardiograms, and baseline and annual electrocardiograms over 3 years.</p><p><strong>Results: </strong>A total of 2,254 participants (34.1% female; mean age: 68.7 years; mean glomerular filtration: rate 41.4 mL/min/m2) enrolled in the study. Baseline LVH (left ventricular mass index &gt;131 g/m2 [&gt;100 g/m2 if female]) was present in 10.8% and prolonged QTc intervals (≥500 ms) in 1.5% of participants. One hundred thirty-eight (6.1%) participants died during the study. In generalized mixed-effects regression, each unit increase in the natural log of FGF23 - but not LVH - predicted an odds ratio of 1.76 (1.15, 2.70, p = 0.009) for prolonged QTc intervals independently of 15 other covariates. Mediation analysis showed that only 13% of FGF23's total effect on prolonged QTc intervals was mediated by LVH. Patients with prolonged QTc intervals had higher unadjusted (log rank p &lt; 0.001) and adjusted (hazard ratio: 2.06 [1.08, 3.92, p = 0.028]) mortality rates than those with QTc intervals &lt;500 ms.</p><p><strong>Discussion: </strong>QTc interval prolongation ≥500 ms was prospectively associated with FGF23 independently of LVH and with increased mortality risk in patients with predialysis CKD.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"45-57"},"PeriodicalIF":3.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107590319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Galectin-3 and Soluble CD146 Identify Cardiorenal Injuries in Severe Burn Patients: A Biomarker-Based Approach. 基于生物标志物的方法:Galectin-3 和可溶性 CD146 识别严重烧伤患者的心肾损伤。
IF 2.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-01-01 Epub Date: 2024-08-12 DOI: 10.1159/000540845
Louis Boutin, Sabri Soussi, Angèle Garcia Lavello, Elisabeth Masson Fron, Banjamin Deniau, Matthieu Legrand, Marcel Blot-Chabaud, Stefanny Muriel Figueroa, Christos Envangelos Chadjichristos, Feriel Azibani, Fançois Dépret

Introduction: Acute kidney injury (AKI) and myocardial injury (MI) are severe conditions in patients with severe burn injury, and combination of both is even worst and is called the cardiorenal syndrome (CRS). Identifying a distinct cardiorenal phenotype could significantly enhance the management of these patients. Galectin-3 (Gal3) and soluble CD146 (sCD146) are biomarkers for renal and cardiac injuries. This study aims to assess the occurrence and reliability of these biomarkers in recognizing CRS in individuals who have been severely burn.

Methods: This study is a single-center prospective proof-of-concept study involving patients with severe burn injuries. Plasma samples for Gal3 and sCD146 measurements were collected daily during the initial 7 days following admission. CRS was defined after 24 h of admission by the association of AKI stage 1 or more (KDIGO definition) and MI defined on high sensitive troponin (hsTnT) (variation >20% baseline value or absolute value >40 ng/mL).

Results: Forty patients met the inclusion criteria and were included in this study. Thirty-eight patients had CRS. The pooled values of Gal3 or combination of Gal3 and sCD146 values following 7 days after admission were associated with CRS with an odds ratio (OR) of 1.145 (95% CI: 1.081-1.211), p < 0.001, and 1.147 (95% CI: 1.085-1.212), p < 0.001, respectively. Gal3 values at admission (D0) had a predictive performance for CRS with an AUC of 0.78 (95% CI: 0.63-0.93), and this performance improved when using the combination of Gal3 and sCD146 values at admission (D0), with an AUC of 0.81 (95% CI: 0.66-0.96). Gal3 levels during the first 7 days were associated with patients experiencing AKI and no MI, with an OR of 1.129 (95% CI: 1.065-1.195), p < 0.001, and MI without AKI with an OR of 1.095 (95% CI: 1.037-1.167), p < 0.001. sCD146 alone was not associated with AKI without MI or MI without AKI and was poorly associated with CRS.

Conclusion: In severely burned patients, CRS is a frequent and severe condition. Gal3 values during the first 7 days following admission were associated with CRS. The use of sCD146 with Gal3 improved prediction performance for CRS identification. The use of such biomarkers to identify CRS is important and needs to be confirmed in other studies.

导言:急性肾损伤(AKI)和心肌损伤(MI)是严重烧伤患者的严重并发症,二者结合则更为严重,被称为心肾综合征(CRS)。确定一种独特的心肾表型可大大提高对这些患者的治疗效果。Galectin-3 (Gal3) 和可溶性 CD146 (sCD146) 是肾脏和心脏损伤的生物标志物。本研究旨在评估这些生物标志物在识别严重烧伤患者的 CRS 方面的发生率和可靠性:本研究是一项涉及严重烧伤患者的单中心前瞻性概念验证研究。在患者入院后的最初 7 天内,每天收集血浆样本以测定 Gal3 和 sCD146。入院 24 小时后,根据 AKI 1 期或 1 期以上(KDIGO 定义)和高敏肌钙蛋白(hsTnT)(变化> 20 %基线值或绝对值> 40 ng/mL)定义的心肌梗死(MI)来定义 CRS:40名患者符合纳入标准并被纳入本研究。38名患者患有CRS。入院 7 天后 Gal3 的汇总值或 Gal3 和 sCD146 的组合值与 CRS 相关,OR 值分别为 1.145 [CI 95% (1.081-1.211)], p < 0.001 和 1.147 [CI 95% (1.085-1.212)], p < 0.001。入院时(D0)的Gal3值对CRS的预测性为0.78 [CI 95% (0.63-0.93)],当使用入院时(D0)的Gal3和sCD146值组合时,预测性有所提高,AUC为0.81 [CI 95% (0.66-0.96)]。前 7 天的 Gal3 水平与患者发生 AKI 和无心肌梗死有关,OR 为 1.129 [CI 95% (1.065-1.195)], p < 0.001,与无 AKI 的心肌梗死有关,OR 为 1.095 [CI 95% (1.037-1.167)], p < 0.001:结论:在严重烧伤患者中,心肾综合征是一种常见且严重的疾病。结论:在严重烧伤患者中,心肾综合征是一种常见的严重病症,入院后前 7 天的 Gal3 值与心肾综合征有关。使用 sCD146 和 Gal3 提高了对 CRS 鉴定的预测性能。使用此类生物标志物来鉴别心肾综合征非常重要,需要在其他研究中加以证实。
{"title":"Galectin-3 and Soluble CD146 Identify Cardiorenal Injuries in Severe Burn Patients: A Biomarker-Based Approach.","authors":"Louis Boutin, Sabri Soussi, Angèle Garcia Lavello, Elisabeth Masson Fron, Banjamin Deniau, Matthieu Legrand, Marcel Blot-Chabaud, Stefanny Muriel Figueroa, Christos Envangelos Chadjichristos, Feriel Azibani, Fançois Dépret","doi":"10.1159/000540845","DOIUrl":"10.1159/000540845","url":null,"abstract":"<p><strong>Introduction: </strong>Acute kidney injury (AKI) and myocardial injury (MI) are severe conditions in patients with severe burn injury, and combination of both is even worst and is called the cardiorenal syndrome (CRS). Identifying a distinct cardiorenal phenotype could significantly enhance the management of these patients. Galectin-3 (Gal3) and soluble CD146 (sCD146) are biomarkers for renal and cardiac injuries. This study aims to assess the occurrence and reliability of these biomarkers in recognizing CRS in individuals who have been severely burn.</p><p><strong>Methods: </strong>This study is a single-center prospective proof-of-concept study involving patients with severe burn injuries. Plasma samples for Gal3 and sCD146 measurements were collected daily during the initial 7 days following admission. CRS was defined after 24 h of admission by the association of AKI stage 1 or more (KDIGO definition) and MI defined on high sensitive troponin (hsTnT) (variation &gt;20% baseline value or absolute value &gt;40 ng/mL).</p><p><strong>Results: </strong>Forty patients met the inclusion criteria and were included in this study. Thirty-eight patients had CRS. The pooled values of Gal3 or combination of Gal3 and sCD146 values following 7 days after admission were associated with CRS with an odds ratio (OR) of 1.145 (95% CI: 1.081-1.211), p &lt; 0.001, and 1.147 (95% CI: 1.085-1.212), p &lt; 0.001, respectively. Gal3 values at admission (D0) had a predictive performance for CRS with an AUC of 0.78 (95% CI: 0.63-0.93), and this performance improved when using the combination of Gal3 and sCD146 values at admission (D0), with an AUC of 0.81 (95% CI: 0.66-0.96). Gal3 levels during the first 7 days were associated with patients experiencing AKI and no MI, with an OR of 1.129 (95% CI: 1.065-1.195), p &lt; 0.001, and MI without AKI with an OR of 1.095 (95% CI: 1.037-1.167), p &lt; 0.001. sCD146 alone was not associated with AKI without MI or MI without AKI and was poorly associated with CRS.</p><p><strong>Conclusion: </strong>In severely burned patients, CRS is a frequent and severe condition. Gal3 values during the first 7 days following admission were associated with CRS. The use of sCD146 with Gal3 improved prediction performance for CRS identification. The use of such biomarkers to identify CRS is important and needs to be confirmed in other studies.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"460-472"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Practical Requirements for the Development of an Advanced Cardiorenal Unit. 发展先进心肾病科的实际要求。
IF 3.8 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-01-01 Epub Date: 2024-02-16 DOI: 10.1159/000536104
Luis Almenar-Bonet, Ignacio Sánchez-Lázaro, Amparo Soldevila, Raquel López-Vilella, Víctor Donoso Trenado, Ramón Devesa, Paula Carmona, Sergi Tormo, María Jesús Montero Hernández, Julio Hernández, Luis Martínez Dolz, Pilar Sánchez-Pérez

Background: Heart failure is frequently associated with kidney disease, and patients with kidney disease are at increased risk of heart failure. The co-occurrence of both entities not only significantly increases morbidity and mortality but also complicates therapy.

Summary: Cardiorenal syndrome often requires a broad, comprehensive, and multidisciplinary approach. As a result, a need has arisen to create specialized cardiorenal units that allow for rigorous and personalized management of this condition. Moreover, in some cases, cardiorenal syndrome is more complex, owing to an acute and critical situation that requires the concept of the cardiorenal unit to be extended toward advanced diagnostic and therapeutic positions, thus confirming the need for an advanced cardiorenal unit. The creation of these units constitutes a real challenge, necessitating a specific multilevel action plan, covering governance and management, type of patient, personnel requirements, service portfolio, care process, information systems, and other resources. Specific lines of action must be proposed for each of the relevant points in order to facilitate development of these units, together with continuous evaluation of unit activity through specific indicators, and to detect areas for improvement.

Key messages: This study addresses the conditions and organizational characteristics that enable the creation, development, and continuous improvement of advanced cardiorenal units.

背景:心力衰竭常常与肾脏疾病相关,而肾脏疾病患者发生心力衰竭的风险也会增加。摘要:心肾综合征通常需要广泛、全面和多学科的治疗方法。因此,有必要建立专门的心肾病科室,以便对这一病症进行严格和个性化的管理。此外,在某些情况下,心肾综合征会因急危重症而变得更加复杂,这就需要将心肾科的概念扩展到先进的诊断和治疗位置,从而证实了对先进心肾科的需求。创建这些单位是一项真正的挑战,需要制定具体的多层次行动计划,包括治理和管理、病人类型、人员要求、服务组合、护理流程、信息系统和其他资源。必须针对每个相关要点提出具体的行动方针,以促进这些单位的发展,同时通过具体指标对单位活动进行持续评估,并发现需要改进的地方。
{"title":"Practical Requirements for the Development of an Advanced Cardiorenal Unit.","authors":"Luis Almenar-Bonet, Ignacio Sánchez-Lázaro, Amparo Soldevila, Raquel López-Vilella, Víctor Donoso Trenado, Ramón Devesa, Paula Carmona, Sergi Tormo, María Jesús Montero Hernández, Julio Hernández, Luis Martínez Dolz, Pilar Sánchez-Pérez","doi":"10.1159/000536104","DOIUrl":"10.1159/000536104","url":null,"abstract":"<p><strong>Background: </strong>Heart failure is frequently associated with kidney disease, and patients with kidney disease are at increased risk of heart failure. The co-occurrence of both entities not only significantly increases morbidity and mortality but also complicates therapy.</p><p><strong>Summary: </strong>Cardiorenal syndrome often requires a broad, comprehensive, and multidisciplinary approach. As a result, a need has arisen to create specialized cardiorenal units that allow for rigorous and personalized management of this condition. Moreover, in some cases, cardiorenal syndrome is more complex, owing to an acute and critical situation that requires the concept of the cardiorenal unit to be extended toward advanced diagnostic and therapeutic positions, thus confirming the need for an advanced cardiorenal unit. The creation of these units constitutes a real challenge, necessitating a specific multilevel action plan, covering governance and management, type of patient, personnel requirements, service portfolio, care process, information systems, and other resources. Specific lines of action must be proposed for each of the relevant points in order to facilitate development of these units, together with continuous evaluation of unit activity through specific indicators, and to detect areas for improvement.</p><p><strong>Key messages: </strong>This study addresses the conditions and organizational characteristics that enable the creation, development, and continuous improvement of advanced cardiorenal units.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"136-146"},"PeriodicalIF":3.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139671377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurohormonal Activation and Renal Chloride Avidity in Acute Heart Failure: Clinical Evidence Supporting the "Chloride Theory". 急性心力衰竭时的神经激素激活和肾脏氯化物活性:支持 "氯化物理论 "的临床证据。
IF 3.8 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI: 10.1159/000536293
Hajime Kataoka

Introduction: Heart failure (HF) progression according to changes in the serum chloride concentration ([sCl-]) was recently proposed as the "chloride (Cl) theory" for HF pathophysiology. The present study examined the association of neurohormones and renal Cl avidity to determine their contribution to acute HF and their involvement to the "Cl theory."

Methods: Data from 29 patients with acute HF (48% men; 80.3 ± 12 years) were analyzed. Blood and urine samples were obtained before decongestive therapy. Clinical tests included peripheral blood, serum and spot urinary electrolytes, b-type natriuretic peptide (BNP), and plasma neurohormones.

Results: In the 29 patients, urinary Cl concentrations ([uCl-]) inversely correlated with log (plasma renin activity [PRA]) (r = -0.64, p = 0.0002) and log (plasma aldosterone concentration) (r = -0.50, p = 0.006). The [sCl-]‒[uCl-] difference positively correlated with log PRA (r = 0.63, p = 0.0002) and log (plasma aldosterone concentration) (r = 0.49, p = 0.008). Patients were divided into 2 groups according to the [sCl-]‒[uCl-] difference, an excretion (low renal Cl avidity) group and an absorption (high renal Cl avidity) group. Compared with the excretion group (-77 to ‒5 mEq/L; n = 14), the absorption group (1-84 mEq/L; n = 15) exhibited greater renal impairment (serum creatinine; 1.45 ± 0.63 vs. 1.00 ± 0.38 mg/d, p = 0.029) and cardiac burden (log BNP; 2.99 ± 0.3 vs. 2.66 ± 0.32 pg/mL, p = 0.008), higher log PRA (0.20 ± 0.58 vs. -0.25 ± 0.35 ng/mL/h, p = 0.018), and lower fractional urinary Cl excretion (1.34 ± 1.3 vs. 5.33 ± 4.1%, p < 0.001).

Conclusion: Renal Cl avidity differs in acute HF, i.e., excretion (low renal Cl avidity) versus absorption (high renal Cl avidity) types, involving renin-aldosterone-angiotensin activity as the underlying mechanism, which provides the neurohormonal background for the "Cl theory." A version of this study was presented in part at the annual international scientific assembly (ACC.23) of the American College of Cardiology, March 4-6, 2023.

导言:根据血清氯化物浓度([sCl-])的变化而导致的心力衰竭(HF)进展最近被提出为HF病理生理学的 "氯化物理论"。本研究探讨了神经激素与肾脏 Cl 效价的关系,以确定它们对急性心力衰竭的贡献及其与 "氯化物理论 "的关系:分析了 29 名急性心房颤动患者(48% 为男性;80.3±12 岁)的数据。在减充血治疗前采集血液和尿液样本。临床检测包括外周血、血清和定点尿电解质、b 型钠尿肽(BNP)和血浆神经激素:在 29 名患者中,尿液中的 Cl 浓度([uCl-])与对数(血浆肾素活性 [PRA])(r=-0.64,p=0.0002)和对数(血浆醛固酮浓度)(r=-0.50,p=0.006)成反比。sCl-]-[uCl-]差异与对数 PRA(r=0.63,p=0.0002)和对数(血浆醛固酮浓度)(r=0.49,p=0.008)呈正相关。根据[sCl-]-[uCl-]差异将患者分为两组,即排泄组(低肾Cl亲和力)和吸收组(高肾Cl亲和力)。与排泄组(-77 至 -5mEq/L;n=14)相比,吸收组(1 至 84mEq/L;n=15)表现出更严重的肾功能损害(血清肌酐;1.45±0.63 vs. 1.00±0.38mg/d,p=0.029)和心脏负担(对数BNP;2.99±0.3 vs. 2.66±0.32pg/mL,p=0.008),更高的对数PRA(0.20±0.58 vs. -0.25±0.35ng/mL/h,p=0.018)和更低的尿Cl排泄分数(1.34±1.3 vs. 5.33±4.1%,p结论:急性高血压患者的肾脏Cl亲和力不同,即排泄型(低肾脏Cl亲和力)与吸收型(高肾脏Cl亲和力),其潜在机制涉及肾素-醛固酮-血管紧张素活性,这为 "氯化物理论 "提供了神经激素背景。
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引用次数: 0
Cardiorenal Impact of Anti-Cancer Agents: The Intersection of Onco-Nephrology and Cardio-Oncology. 抗癌药物对心肾功能的影响:肿瘤肾脏病学与心脏肿瘤学的交汇点。
IF 3.8 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-01-01 Epub Date: 2024-04-29 DOI: 10.1159/000539075
Rose Mary Attieh, Belen Nunez, Robert S Copeland-Halperin, Kenar D Jhaveri

Background: The evolving landscape of cancer treatments has introduced new challenges, particularly related to adverse events associated with chemotherapeutic agents. To address these challenges, the fields of cardio-oncology and onco-nephrology have arisen, focusing on the management of cardiotoxicity and nephrotoxicity attributable to anti-cancer drugs.

Summary: Numerous intersections between these disciplines exist, including onco-hypertension (HTN) and cardiorenal toxicities induced by chemotherapeutic agents. Additionally, immune checkpoint inhibitors (ICIs) may cause myocarditis and nephritis. This paper aimed to explore the intersection between cardio-oncology and onco-nephrology. A detailed review will be undertaken, focusing on onco-HTN and the cardiorenal toxicities of chemotherapeutic agents, with a specific emphasis on the adverse effects associated with ICIs.

Key messages: Multidisciplinary collaboration among oncologists, cardiologists, nephrologists, and other healthcare professionals is crucial for developing tailored approaches to optimize treatment efficacy while minimizing the risk of cardiovascular and renal complications, ultimately enhancing patient outcomes in modern oncology practice.

癌症治疗领域的不断发展带来了新的挑战,尤其是与化疗药物相关的不良反应。为了应对这些挑战,心肿瘤学和肿瘤肾脏病学领域应运而生,重点研究抗癌药物引起的心脏毒性和肾毒性。这些学科之间存在许多交叉点,包括化疗药物诱发的肿瘤高血压和心肾毒性。此外,免疫检查点抑制剂可能导致心肌炎和肾炎。肿瘤学家、心脏病学家、肾脏病学家和其他医疗保健专业人士之间的多学科合作对于制定量身定制的方法至关重要,以便在优化治疗效果的同时最大限度地降低心血管和肾脏并发症的风险,最终提高现代肿瘤学实践中患者的治疗效果。
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引用次数: 0
Long-Term Clinical Outcomes of Acute Kidney Disease in Patients Receiving Extracorporeal Membrane Oxygenation. 接受体外膜氧合治疗的急性肾病患者的长期临床疗效。
IF 2.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-01-01 Epub Date: 2024-05-02 DOI: 10.1159/000539151
Ming-Jen Chan, Shao-Wei Chen, Pei-Chun Fan, Cheng-Chia Lee, Jia-Jin Chen, George Kuo, Yung-Chang Chen, Chih-Hsiang Chang

Introduction: Extracorporeal membrane oxygenation (ECMO) is widely used; however, studies on the long-term outcomes of ECMO are scarce. We investigated the long-term clinical outcomes of acute kidney disease (AKD) in patients receiving ECMO.

Methods: Electronic data (2009-2018) were retrospectively collected from a multicenter database. Patients were divided into two groups (AKD and non-AKD) according to their AKD status 8-90 days after the initiation of ECMO. Inverse probability of treatment weighting was used to balance baseline covariates between the two groups. The primary outcomes were major adverse kidney events (MAKEs) and major adverse cardiovascular events (MACEs), and the secondary outcomes were all-cause readmission, sepsis-related readmission, infection-related readmission, and dementia.

Results: Totally, 395 patients were eligible for analysis; of them, 160 patients (40.5%) developed AKD. The AKD group had a higher risk of MAKEs (hazard ratio [HR]: 2.06; 95% confidence interval [CI]: 1.68-2.53) than did the non-AKD group. Subgroup analysis revealed that the observed unfavorable effect of AKD on the risk of MAKEs was more pronounced in patients receiving venovenous ECMO than in those receiving venoarterial ECMO (HR: 5.69 vs. 1.85, respectively; p for interaction = 0.004). AKD group had a higher risk of MACE during the initial 3-year post-ECMO in comparison to those without (HR: 1.68; 95% CI: 1.22-2.30). Moreover, the risks of all-cause, sepsis-related, and infection-related readmissions were high in AKD survivors.

Conclusions: AKD is associated with an increased risk of long-term MAKEs and initial 3-year MACE in ECMO recipients. In addition, AKD is associated with increased risks of all-cause, infection-related, and sepsis-related readmissions.

导言:体外膜肺氧合(ECMO)已被广泛应用,但有关ECMO长期疗效的研究却很少。我们调查了接受 ECMO 患者急性肾病(AKD)的长期临床结果:我们从一个多中心数据库中回顾性收集了电子数据(2009-2018 年)。根据患者在开始 ECMO 8-90 天后的 AKD 状态将其分为两组(AKD 和非 AKD)。采用逆概率治疗加权法(IPTW)平衡两组患者的基线协变量。主要结果为主要肾脏不良事件(MAKE)和主要心血管不良事件(MACE),次要结果为全因再入院、脓毒症相关再入院、感染相关再入院和痴呆:共有395名患者符合分析条件,其中160名患者(40.5%)出现了急性心肌梗死。与非 AKD 组相比,AKD 组发生 MAKE 的风险更高(危险比 [HR]:2.06;95% 置信区间 [CI]:1.68-2.53)。亚组分析显示,观察到的 AKD 对 MAKEs 风险的不利影响在接受静脉 ECMO 的患者中比在接受静脉动脉 ECMO 的患者中更为明显(HR:分别为 5.69 对 1.85;交互作用 P = 0.004)。与未接受 ECMO 的患者相比,AKD 组患者在接受 ECMO 后的最初 3 年中发生 MACE 的风险更高(HR:1.68;95% CI:1.22-2.30)。此外,AKD幸存者的全因、脓毒症相关和感染相关再入院风险较高:结论:AKD 与 ECMO 受者长期 MAKEs 和最初 3 年 MACE 风险增加有关。结论:AKD 与 ECMO 受者长期 MAKEs 和最初 3 年 MACE 风险增加有关,此外,AKD 与全因、感染相关和败血症相关再入院风险增加有关。
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引用次数: 0
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Cardiorenal Medicine
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