Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan.
Nephron Clin Pract. 2011;117(4):c341-7. doi: 10.1159/000321512. Epub 2010 Oct 15.
A majority of patients with chronic kidney disease (CKD) have cardiovascular disease at the initiation of dialysis therapy, suggesting that periodic echocardiographic examinations are important in such patients. The purpose of the present study was to evaluate the correlation between echocardiographic parameters and period of time before initiation of hemodialysis (iHD) in patients with CKD.
140 patients with CKD stages 4 and 5 were enrolled. They were divided into diabetes and nondiabetes groups. Cardiac predictive parameters for the period of time before iHD were investigated in the patients using univariate and multivariate regression analyses.
In the nondiabetes group, systolic blood pressure (SBP) and left atrial volume index (LAVi) were identified as independent risk factors for the period of time before iHD by multivariate regression analysis. Serum albumin level was identified as an independent risk factor in the diabetes group. SBP, LAVi and serum albumin level were identified as independent risk factors in the combined diabetes and nondiabetes groups.
LAVi measurements during echocardiography, together with SBP and serum albumin levels, may be useful predictive factors for the period of time before iHD in patients with CKD stages 4 and 5.
大多数慢性肾脏病（CKD）患者在开始透析治疗时就患有心血管疾病，这表明周期性超声心动图检查对这些患者很重要。本研究的目的是评估 CKD 患者超声心动图参数与开始血液透析（iHD）前时间的相关性。
纳入 140 名 CKD 4 期和 5 期患者。他们分为糖尿病组和非糖尿病组。使用单因素和多因素回归分析调查了患者开始 iHD 前时间的心脏预测参数。
在非糖尿病组中，通过多因素回归分析，收缩压（SBP）和左心房容积指数（LAVi）被确定为开始 iHD 前时间的独立危险因素。血清白蛋白水平是糖尿病组的独立危险因素。在糖尿病和非糖尿病合并组中，SBP、LAVi 和血清白蛋白水平被确定为独立危险因素。
在 CKD 4 期和 5 期患者中，超声心动图测量的 LAVi 与 SBP 和血清白蛋白水平一起，可能是开始 iHD 前时间的有用预测因子。
