Division of Nephrology, Department of Medicine, Mitsui Memorial Hospital, Tokyo, Japan.
Blood Purif. 2011;31(4):276-80. doi: 10.1159/000322408. Epub 2011 Jan 14.
BACKGROUND/AIMS: A significant number of uremic patients develop ischemic heart disease before hemodialysis (HD) is initiated. Recently, chronic cardiorenal syndrome among predialysis patients has been recognized. However, little is known about prognostic factors in this subgroup of incident HD patients.
A total of 87 incident HD patients, who were classified into cardiorenal syndrome type 4 (chronic cardiorenal syndrome), were identified at Mitsui Memorial Hospital between 1984 and 2003. The survival and risk factors for mortality were examined.
25 patients died and the 5-year survival rate amounted to approximately 75%. Both all-cause mortality and the adjusted mortality for age and sex were higher in patients with a lower serum albumin level (p = 0.03) or higher serum C-reactive protein level (p = 0.02).
The poor survival rate of incident HD patients with a medical history of ischemic heart disease was predicted by malnutrition and inflammation at the start of HD.
背景/目的：在开始血液透析 (HD) 之前，相当数量的尿毒症患者会发生缺血性心脏病。最近，人们已经认识到透析前患者存在慢性心肾综合征。然而，对于这组新发生的 HD 患者亚组，其预后因素知之甚少。
1984 年至 2003 年间，在三井纪念医院共确定了 87 例新发生的 HD 患者，将其分为 4 型心肾综合征（慢性心肾综合征）。检查了生存情况和死亡风险因素。
25 例患者死亡，5 年生存率约为 75%。低血清白蛋白水平（p = 0.03）或高血清 C 反应蛋白水平（p = 0.02）的患者，全因死亡率和调整年龄及性别后的死亡率更高。
HD 开始时存在营养不良和炎症的新发生 HD 患者具有较差的生存率。
