Division of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Exp Gerontol. 2012 Dec;47(12):950-7. doi: 10.1016/j.exger.2012.08.012. Epub 2012 Sep 5.
The incidence of chronic kidney disease (CKD) is on the rise. CKD patients are at high risk of cardiovascular (CVD) and all-cause mortality. CKD patients have several endocrine disorders, including low levels of dehydroepiandrosterone sulfate (DHEA-S). In the general population, low levels of DHEA-S are associated with high CVD and all-cause mortality. The aim of this study was to analyze the prognostic value of plasma DHEA-S on the survival of CKD patients on hemodialysis.
This was a single-center prospective cohort study on two hundred CKD patients on hemodialysis, which assessed the prognostic value of plasma DHEA-S on their survival.
We found that plasma DHEA-S levels were negatively associated with age, and positively associated with dialysis duration and plasma creatinine, albumin, and phosphate levels in hemodialysis men. Elderly patients with co-morbidities (i.e. diabetes mellitus, congestive heart failure, and chronic obstructive pulmonary disease), poorer fluid control which was evaluated by higher cardiothoracic ratio, and low plasma creatinine and albumin levels seemed to have poor prognosis in hemodialysis men. Furthermore, low plasma DHEA-S levels were significantly associated with CVD-related [hazard ratio (HR)=3.877; P=0.021], non-CVD-related (HR=3.522; P=0.016), and all-cause mortality (HR=3.667; P=0.001) in hemodialysis men. But low plasma DHEA-S levels were not significantly associated with CVD-related, non-CVD-related, and all-cause mortality in hemodialysis women. Multivariate Cox regression analysis suggested that low plasma DHEA-S levels are significantly and independently associated with all-cause mortality in hemodialysis men (HR=2.933; P=0.033).
The study suggested that low plasma DHEA-S was independently and significantly associated with all-cause mortality in CKD hemodialysis men.
慢性肾脏病（CKD）的发病率正在上升。CKD 患者患心血管疾病（CVD）和全因死亡率的风险很高。CKD 患者存在多种内分泌紊乱，包括硫酸脱氢表雄酮（DHEA-S）水平降低。在一般人群中，DHEA-S 水平降低与 CVD 和全因死亡率升高有关。本研究旨在分析血浆 DHEA-S 对血液透析 CKD 患者生存的预后价值。
这是一项针对 200 名血液透析 CKD 患者的单中心前瞻性队列研究，评估了血浆 DHEA-S 对其生存的预后价值。
我们发现，血液透析男性中，血浆 DHEA-S 水平与年龄呈负相关，与透析时间和血浆肌酐、白蛋白和磷酸盐水平呈正相关。患有合并症（即糖尿病、充血性心力衰竭和慢性阻塞性肺疾病）的老年患者、心胸比更高提示液体控制较差的患者，以及血浆肌酐和白蛋白水平较低的患者，似乎在血液透析男性中预后较差。此外，低血浆 DHEA-S 水平与 CVD 相关（危险比[HR]=3.877；P=0.021）、非 CVD 相关（HR=3.522；P=0.016）和全因死亡率（HR=3.667；P=0.001）显著相关。但是，低血浆 DHEA-S 水平与血液透析女性的 CVD 相关、非 CVD 相关和全因死亡率无显著相关性。多变量 Cox 回归分析表明，低血浆 DHEA-S 水平与血液透析男性的全因死亡率显著相关（HR=2.933；P=0.033）。
该研究表明，低血浆 DHEA-S 与 CKD 血液透析男性的全因死亡率独立且显著相关。
