Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Clin Exp Nephrol. 2013 Apr;17(2):268-74. doi: 10.1007/s10157-012-0674-7. Epub 2012 Aug 2.
There is a lack of information on stiffness parameter β, an index of arterial stiffness, in hemodialysis (HD) patients. The aim of the present study was to investigate whether stiffness parameter β is predictive of the long-term mortality of chronic HD patients.
We measured biochemical parameters and the stiffness parameter β of 80 patients on maintenance HD therapy and followed their course for 4 years, and we enrolled 70 of these 80 patients in the study. We divided the 70 patients into tertiles according to their stiffness parameter β values, and conducted multivariate analyses to examine the impact of the tertiles on 4-year mortality.
Older age and the presence of diabetes mellitus were found to be independently associated with higher stiffness parameter β values. Fifteen patients (21.4 %) died and 16 (22.9 %) experienced a new cardiovascular event during the follow-up period. The results of a Kaplan-Meier analysis revealed a significantly higher risk of all-cause mortality in the HD patients with highest stiffness parameter β values (p = 0.0106). According to the ROC curve, the cut-off level that yielded maximal sensitivity and specificity for predicting all-cause mortality was 10.1, and the sensitivity and specificity using the cut-off value were 69.2 and 70.2 %, respectively.
The results of this study suggest that stiffness parameter β is a predictor of all-cause mortality in chronic HD patients.
血液透析（HD）患者的动脉僵硬指数硬度参数β的信息有限。本研究旨在探讨硬度参数β是否可预测慢性 HD 患者的长期死亡率。
我们测量了 80 名维持性 HD 治疗患者的生化参数和硬度参数β，并对他们进行了 4 年的随访，其中 70 名患者纳入本研究。我们根据硬度参数β值将这 70 名患者分为 3 组，并进行多变量分析，以检验各组对 4 年死亡率的影响。
年龄较大和患有糖尿病与较高的硬度参数β值独立相关。15 名患者（21.4%）在随访期间死亡，16 名（22.9%）发生新的心血管事件。Kaplan-Meier 分析结果显示，硬度参数β值最高的 HD 患者全因死亡率显著升高（p=0.0106）。根据 ROC 曲线，预测全因死亡率的最佳截断值为 10.1，使用该截断值的敏感性和特异性分别为 69.2%和 70.2%。
本研究结果表明，硬度参数β是慢性 HD 患者全因死亡率的预测指标。
