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血液透析患者的心血管状况可能会因透析间期体重过度增加而恶化。

Cardiovascular conditions in hemodialysis patients may be worsened by extensive interdialytic weight gain.

作者信息

Holmberg Benny, Stegmayr Bernd G

机构信息

Department of Internal Medicine, University Hospital, Umeå, Sweden.

出版信息

Hemodial Int. 2009 Jan;13(1):27-31. doi: 10.1111/j.1542-4758.2009.00335.x.

Abstract

The risk of death is increased for hemodialysis (HD) patients compared with age-matched healthy subjects, the main reason for this being cardiovascular conditions. This prospective study investigated whether the burden of interdialytic weight gain (IDWG) was of importance for cardiovascular end points and survival. A total of 97 HD patients were studied. The end points included death (reasons given), acute myocardial infarction, or coronary vascular intervention. The extent of ultrafiltration was measured at predefined follow-up points. The IDWG was calculated as ultrafiltration/body weight given in weight%. The burden of IDWG was analyzed. End points occurred in 77 (79%) of the patients during the 5-year study period. The extent of IDWG was higher in those with end points due to cardiovascular reasons (3.77 weight% vs. 3.19 P<0.001), cardiac reasons (P<0.001), congestive heart failure (P<0.01), aortic aneurysm, and intracerebral bleeding (P<0.024). To reduce the risk for cardiovascular events, it is important to avoid too extensive IDWG in HD patients.

摘要

与年龄匹配的健康受试者相比,血液透析(HD)患者的死亡风险增加,主要原因是心血管疾病。这项前瞻性研究调查了透析间期体重增加(IDWG)的负担对心血管终点和生存是否重要。共研究了97例HD患者。终点包括死亡(给出原因)、急性心肌梗死或冠状动脉血管介入。在预定的随访点测量超滤程度。IDWG计算为超滤量/体重(以体重百分比表示)。分析了IDWG的负担。在5年研究期间,77例(79%)患者出现终点事件。因心血管原因(3.77%体重 vs. 3.19%,P<0.001)、心脏原因(P<0.001)、充血性心力衰竭(P<0.01)、主动脉瘤和脑出血(P<0.024)出现终点事件的患者,其IDWG程度更高。为降低心血管事件风险,避免HD患者出现过度的IDWG很重要。

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