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长期功能良好的血液透析血管通路与肾移植受者左心室肥厚患病率的关系。

The association of long-functioning hemodialysis vascular access with prevalence of left ventricular hypertrophy in kidney transplant recipients.

机构信息

Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Francuska Street 20/24, 40-027 Katowice, Poland.

Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Francuska Street 20/24, 40-027 Katowice, Poland ; Department of Pathophysiology, Medical University of Silesia, 40-752 Katowice, Poland.

出版信息

Biomed Res Int. 2014;2014:603459. doi: 10.1155/2014/603459. Epub 2014 Jan 28.

Abstract

Left ventricular hypertrophy (LVH) is frequently observed in chronic dialysis patients and is also highly prevalent in kidney transplant recipients. This study evaluates the impact of long-functioning hemodialysis vascular access on LVH in single center cohort of kidney transplant recipients. 162 patients at 8.7 ± 1.8 years after kidney transplantation were enrolled. Echocardiography, carotid ultrasound, and assessment of pulse wave velocity were performed. LVH was defined based on left ventricular mass (LVM) indexed for body surface area (BSA) and height(2.7). There were 67 patients with and 95 without patent vascular access. Both study groups were comparable with respect to gender, age, duration of dialysis therapy, and time after transplantation, kidney graft function, and cardiovascular comorbidities. Patients with patent vascular access were characterized by significantly elevated LVM and significantly greater percentage of LVH, based on LVMI/BSA (66.7 versus 48.4%, P = 0.02). OR for LVH in patients with patent vascular access was 2.39 (1.19-4.76), P = 0.01. Regression analyses confirmed an independent contribution of patent vascular access to higher LVM and increased prevalence of LVH. We concluded that long-lasting patent hemodialysis vascular access after kidney transplantation is associated with the increased prevalence of LVH in kidney transplant recipients.

摘要

左心室肥厚(LVH)在慢性透析患者中经常观察到,在肾移植受者中也非常普遍。本研究评估了长期功能良好的血液透析血管通路对单中心队列肾移植受者 LVH 的影响。162 例患者在肾移植后 8.7±1.8 年入组。进行了超声心动图、颈动脉超声和脉搏波速度评估。LVH 根据左心室质量(LVM)与体表面积(BSA)和身高(2.7)的比值进行定义。有 67 例患者有和 95 例患者无通畅的血管通路。两组患者在性别、年龄、透析治疗时间和移植后时间、肾脏移植物功能和心血管合并症方面具有可比性。具有通畅血管通路的患者 LVM 明显升高,LVH 的百分比明显更高,基于 LVMI/BSA(66.7%比 48.4%,P=0.02)。具有通畅血管通路的患者发生 LVH 的 OR 为 2.39(1.19-4.76),P=0.01。回归分析证实,通畅的血管通路对更高的 LVM 和 LVH 发生率的增加具有独立贡献。我们得出结论,肾移植后长期通畅的血液透析血管通路与肾移植受者 LVH 的发生率增加有关。

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