Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Nefrologia. 2013;33(4):539-45. doi: 10.3265/Nefrologia.pre2013.May.11895.
Cardiovascular events (CV) are the major cause of mortality in chronic kidney disease patients (CKD). The aim of the present study was to determine the independent predictors of CV and mortality in CKD patients (stages 1-4).
A prospective study was conducted with 218 patients (62% male), with a median age of 69 years (interquartile range 56-78). Basally, demographic variables, CV risk factors and biochemical values were collected. During follow-up, new CV events and deaths were collected (final variable).
During follow-up (38 [37-39] months), 50 patients suffered a final event: 37 patients (17%) had a CV and 13 (6%) died due to a non-CV death. Having a final event was associated to male sex, smoker, diabetes mellitus, history of CV event, low diastolic blood pressure values, low glomerular filtration, urine albumin/creatinine higher than 1000 mg/g, higher troponin T levels, higher BNP levels, higher CRP levels and lower haemoglobin levels. Multivariate analysis, showed that only male sex, diabetes mellitus, previous CV event and lower glomerular filtration independently predicted having the final event.
Male sex, diabetes mellitus, previous CV event and lower glomerular filtration independently predicted having a CV event or death in CKD patients. We could not demonstrate the superiority of emerging CV risk markers compared to the classic ones.
心血管事件(CV)是慢性肾脏病患者(CKD)死亡的主要原因。本研究的目的是确定 CKD 患者(1-4 期)CV 和死亡率的独立预测因素。
进行了一项前瞻性研究,共纳入 218 名患者(62%为男性),中位年龄为 69 岁(四分位距 56-78)。在基线时收集了人口统计学变量、CV 危险因素和生化值。在随访期间,收集了新的 CV 事件和死亡(最终变量)。
在随访期间(38 [37-39] 个月),50 名患者发生了最终事件:37 名患者(17%)发生了 CV,13 名(6%)死于非 CV 死亡。发生最终事件与男性、吸烟者、糖尿病、CV 事件史、舒张压低、肾小球滤过率低、尿白蛋白/肌酐比高于 1000mg/g、肌钙蛋白 T 水平高、BNP 水平高、CRP 水平高和血红蛋白水平低有关。多变量分析显示,只有男性、糖尿病、既往 CV 事件和肾小球滤过率低独立预测发生最终事件。
男性、糖尿病、既往 CV 事件和肾小球滤过率低独立预测 CKD 患者发生 CV 事件或死亡。我们无法证明新兴的 CV 风险标志物比经典标志物具有优越性。