Suppr超能文献

冠状动脉钙化和磷结合剂选择对新发血液透析患者死亡率的影响

Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients.

作者信息

Block G A, Raggi P, Bellasi A, Kooienga L, Spiegel D M

机构信息

Clinical Research Division, Denver Nephrology, Denver, CO 80230, USA.

出版信息

Kidney Int. 2007 Mar;71(5):438-41. doi: 10.1038/sj.ki.5002059. Epub 2007 Jan 3.

Abstract

The risk of death in hemodialysis patients treated with calcium-containing phosphate binders or sevelamer is not known. We assessed all-cause mortality in 127 patients new to hemodialysis assigned to calcium-containing binders or sevelamer after a median follow-up of 44 months from randomization. This was a predetermined secondary end point of a randomized clinical trial designed to assess progression of coronary artery calcium (CAC) scores in the two treatment arms. Thirty-four deaths occurred during the follow-up period: 23 in subjects randomized to calcium-containing phosphate binders and 11 in subjects randomized to sevelamer. Baseline CAC score was a significant predictor of mortality after adjustment for age, race, gender, and diabetes with increased mortality proportional to baseline score (P=0.002). Mortality was borderline significantly lower in subjects randomized to sevelamer (5.3/100 patient years, confidence interval (CI) (2.2-8.5) compared to those randomized to calcium-containing binders (10.6/100 patient years, CI 6.3-14.9) (P=0.05). The greater risk of death for patients treated with calcium-containing phosphate binders persisted after full multivariable adjustment (P=0.016, hazard ratio 3.1, CI 1.23-7.61). In subjects new to hemodialysis baseline CAC score was a significant predictor of all-cause mortality. Treatment with sevelamer was associated with a significant survival benefit as compared to the use of calcium-containing phosphate binders.

摘要

接受含钙磷结合剂或司维拉姆治疗的血液透析患者的死亡风险尚不清楚。我们评估了127例新接受血液透析患者的全因死亡率,这些患者在随机分组后经过44个月的中位随访,被分配接受含钙结合剂或司维拉姆治疗。这是一项随机临床试验预先设定的次要终点,该试验旨在评估两个治疗组中冠状动脉钙化(CAC)评分的进展情况。随访期间有34例死亡:随机接受含钙磷结合剂治疗的受试者中有23例死亡,随机接受司维拉姆治疗的受试者中有11例死亡。在对年龄、种族、性别和糖尿病进行校正后,基线CAC评分是死亡率的显著预测因素,死亡率与基线评分成正比增加(P = 0.002)。随机接受司维拉姆治疗的受试者的死亡率略低于随机接受含钙结合剂治疗的受试者(5.3/100患者年,置信区间(CI)(2.2 - 8.5)),后者为(10.6/100患者年,CI 6.3 - 14.9)(P = 0.05)。在进行全面多变量校正后,接受含钙磷结合剂治疗的患者死亡风险更高的情况仍然存在(P = 0.016,风险比3.1,CI 1.23 - 7.61)。在新接受血液透析的受试者中,基线CAC评分是全因死亡率的显著预测因素。与使用含钙磷结合剂相比,司维拉姆治疗具有显著的生存获益。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验