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终末期肾病患者接受肾脏替代治疗后新发心房颤动的发生率及相关危险因素。

Incidence and risk factors for new-onset atrial fibrillation among patients with end-stage renal disease undergoing renal replacement therapy.

机构信息

1] Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan [2] Institute of Clinical Medicine and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.

1] Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan [2] Institute of Public Health and School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Kidney Int. 2015 Jun;87(6):1209-15. doi: 10.1038/ki.2014.393. Epub 2015 Jan 14.

Abstract

Atrial fibrillation (AF) is prevalent in end-stage renal disease (ESRD) patients and negatively impacts patient outcomes. We explored the incidence and risk factors for new-onset AF among patients with ESRD undergoing renal replacement therapy, without a prior history of AF, retrieved from Taiwan's National Health Insurance Research Database (NHIRD). For each of 134,901 patients with ESRD, one age- and gender-matched control and one similarly matched patient with chronic kidney disease (CKD), a total of 404,703 patients, were selected from the NHIRD. The study endpoint was the occurrence of new-onset AF and patients were followed an average of 5.1 years. The incidence rates of AF were 12.1, 7.3, and 5.0 per 1000 person-years for ESRD, CKD, and control patients, respectively. Among patients with ESRD, age, hypertension, heart failure, coronary artery disease, peripheral arterial occlusive disease, and chronic obstructive pulmonary disease were significant risk factors for new-onset AF. Thus, patients with ESRD had a significantly higher risk of new-onset AF. The presence of multiple risk factors was associated with a higher possibility of AF occurrence.

摘要

心房颤动(AF)在终末期肾病(ESRD)患者中较为常见,会对患者的预后产生负面影响。本研究旨在探讨台湾全民健康保险研究数据库(NHIRD)中无 AF 既往史的 ESRD 患者接受肾脏替代治疗后新发 AF 的发生率和危险因素。从 NHIRD 中为每 134901 例 ESRD 患者选择了 1 名年龄和性别匹配的对照患者和 1 名同样匹配的慢性肾脏病(CKD)患者,共纳入 404703 例患者。研究终点为新发 AF 的发生,患者平均随访 5.1 年。AF 的发生率分别为 ESRD、CKD 和对照患者的 12.1、7.3 和 5.0/1000 人年。在 ESRD 患者中,年龄、高血压、心力衰竭、冠状动脉疾病、外周动脉闭塞性疾病和慢性阻塞性肺疾病是新发 AF 的显著危险因素。因此,ESRD 患者新发 AF 的风险显著增加。存在多种危险因素与 AF 发生的可能性增加相关。

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