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动脉僵硬度与肾功能正常/早期慢性肾脏病患者的下降。

Arterial stiffness and declines in individuals with normal renal function/early chronic kidney disease.

机构信息

Second Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Tokyo, Japan.

出版信息

Atherosclerosis. 2010 Sep;212(1):345-50. doi: 10.1016/j.atherosclerosis.2010.05.033. Epub 2010 Jun 1.

Abstract

OBJECTIVE

We evaluated the temporal association between arterial stiffening and the early stage of renal functional decline.

METHODS

In 2053 Japanese employees with an estimated glomerular filtration rate (GFR) of > or = 60 ml/min/1.73 m(2) plus no proteinuria (40+/-8 years old) at the start, brachial-ankle pulse wave velocity (baPWV) and serum C-reactive protein (CRP) were measured before and after a 5-6-year follow-up period.

RESULTS

After adjusting for confounding variables including serum CRP levels, higher baseline baPWV was associated with lower follow-up GFR (value expressed as per doubling: -16; 95% confidence interval: -24 to -9; P<0.01) and with higher annual rate of decline in GFR (value expressed as per doubling: -3; 95% confidence interval: -4 to -2; P<0.01). Every m/s higher baPWV was associated with a 36% increased odds (95% CI 1.09-1.70; P<0.01) for a development of a GFR <60 ml/min/1.73 m(2) at follow-up. In contrast, baseline GFR was not associated with follow-up baPWV (P=0.08) or the annual rate of change in baPWV (P=0.11).

CONCLUSION

In a Japanese occupational cohort with normal renal function/early chronic kidney disease, elevated arterial stiffness was an independent risk factor for the decline in renal function. CRP did not appear to exert any significant influence on this association.

摘要

目的

我们评估了动脉僵硬度与肾功能早期下降之间的时间关联。

方法

在 2053 名日本员工中,肾小球滤过率(GFR)估计值>或= 60 ml/min/1.73 m²且无蛋白尿(40+/-8 岁),在开始时测量肱踝脉搏波速度(baPWV)和血清 C 反应蛋白(CRP),随访 5-6 年后再次测量。

结果

在校正了包括血清 CRP 水平在内的混杂变量后,较高的基线 baPWV 与较低的随访 GFR 相关(用倍增表示的数值:-16;95%置信区间:-24 至-9;P<0.01),与 GFR 每年下降速度加快相关(用倍增表示的数值:-3;95%置信区间:-4 至-2;P<0.01)。baPWV 每增加 1 m/s,发展为 GFR<60 ml/min/1.73 m²的可能性增加 36%(95%CI 1.09-1.70;P<0.01)。相比之下,基线 GFR 与随访时的 baPWV (P=0.08)或 baPWV 的年变化率(P=0.11)无关。

结论

在肾功能正常/早期慢性肾脏病的日本职业队列中,动脉僵硬度升高是肾功能下降的独立危险因素。CRP 似乎对这种关联没有任何显著影响。

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