慢性肾病患者的蛋白尿水平与心血管疾病事件风险和全因死亡率之间的非线性关系。

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-02-12 DOI:10.1080/0886022X.2024.2310727
Haiying Song, Yuheng Liao, Haofei Hu, Qijun Wan
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引用次数: 0

摘要

背景:蛋白尿水平与慢性肾脏病(CKD)患者心血管疾病(CVD)的发生和全因死亡率之间的关系仍存在争议:慢性肾脏病(CKD)患者的蛋白尿水平与心血管疾病(CVD)发展和全因死亡率之间的关系仍存在争议:在这项调查中,我们进行了一项回顾性分析,涉及在 CKD-治疗和流行病学结果研究(ROUTE)中登记的 1138 名患者。这项研究的主要结果是心血管事件或全因死亡的复合结果。研究采用了 Cox 比例危险回归、平滑曲线拟合、分段线性回归和亚组分析等方法:研究对象的平均年龄为(67.3 ± 13.6)岁。经多变量调整后,与低度组相比,中度组和高度组 UPCR 的调整后危险比(HRs)分别为 1.93(95% CI:1.28-2.91)和 4.12(95% CI:2.87-5.92)。进一步调整后,两者之间仍存在明显关联;中组和高组的 HR 分别为 1.71(95% CI:1.12-2.61)和 3.07(95% CI:2.08-4.54)。观察到 UPCR 与主要预后之间存在非线性关系,在 3.93 g/gCr 时出现拐点:结论:在未接受透析的 G2 至 G5 期慢性肾脏病患者中,UPCR 与主要预后之间存在非线性关系。较高的 UPCR(当 UPCR < 3.93 g/gCr 时)是主要预后的独立预测因子。重要的是,我们的研究早于 SGLT2 抑制剂的使用,展示了不使用这些药物也能达到的结果。未来的研究将考虑 SGLT2 抑制剂的使用等因素。
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Nonlinear association between proteinuria levels and the risk of cardiovascular disease events and all-cause mortality among chronic kidney disease patients.

Background: The association between proteinuria levels and cardiovascular disease (CVD) development and all-cause mortality in chronic kidney disease (CKD) patients remains controversial.

Methods: In this investigation, we conducted a retrospective analysis involving 1138 patients who were registered in the CKD-Research of Outcomes in Treatment and Epidemiology (ROUTE) study. The primary outcome of this study was the composite of cardiovascular events or all-cause death. Cox proportional hazards regression, smooth curve fitting, piecewise linear regression, and subgroup analyses were used.

Results: The mean age of the included individuals was 67.3 ± 13.6 years old. Adjusted hazard ratios (HRs) for UPCR in middle and high groups, compared to the low group, were 1.93 (95% CI: 1.28-2.91) and 4.12 (95% CI: 2.87-5.92), respectively, after multivariable adjustment. Further adjustments maintained significant associations; HRs for middle and high groups were 1.71 (95% CI: 1.12-2.61) and 3.07 (95% CI: 2.08-4.54). A nonlinear UPCR-primary outcome relationship was observed, with an inflection point at 3.93 g/gCr.

Conclusion: Among non-dialyzed patients with stage G2-G5 CKD, a nonlinear association between UPCR and the primary outcome was observed. A higher UPCR (when UPCR < 3.93 g/gCr) was an independent predictor of the primary outcome. Importantly, our study predates SGLT2 inhibitor use, showcasing outcomes achievable without these medications. Future research considerations will involve factors like SGLT-2 inhibitor utilization.

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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
期刊最新文献
The use of urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin for diagnosis of hepato-renal syndrome in advanced cirrhotic patients. Identification of common and specific fibrosis-related genes in three common chronic kidney diseases. A Mendelian randomization study: physical activities and chronic kidney disease. Association between normal saline infusion volume in the emergency department and acute kidney injury in heat stroke patients: a multicenter retrospective study. Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study.
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