高血压患者痛风疾病控制与终末期肾病发病之间有何关联？一项基于人群的研究结果。

Any link of gout disease control among hypertensive patients and onset of end-stage renal disease? Results from a population-based study.

作者信息

Perreault Sylvie, Nuevo Javier, Baumgartner Scott, Morlock Robert

机构信息

Sylvie Perreault, Faculty of Pharmacy, University of Montreal, Montreal, QC H3C 3J7, Canada.

出版信息

World J Nephrol. 2017 May 6;6(3):132-142. doi: 10.5527/wjn.v6.i3.132.

DOI:10.5527/wjn.v6.i3.132

PMID:28540203

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5424435/

Abstract

AIM

To determine the impact of allopurinol non-adherence as a proxy for uncontrolled disease on primary prevention of end-stage renal disease (ESRD).

METHODS

A cohort of 2752 patients with gout diagnosis was reconstructed using the Québec Régie de l'assurance maladie du Québec and MedEcho administrative databases. Eligible patients were new users of allopurinol, aged 45-85, with a diagnosis of hypertension, and treated with an antihypertensive drug between 1997 and 2007.

RESULTS

Major risk factor for ESRD onset was chronic kidney disease at stages 1 to 3 [rate ratio (RR) = 8.00; 95% confidence interval (CI): 3.16-22.3 and the severity of hypertension (≥ 3 < 3 antihypertensives)] was a trending risk factor as a crude estimate (RR = 1.94; 95%CI: 0.68-5.51). Of 341 patients, cases ( = 22) and controls ( = 319), high adherence level (≥ 80%) to allopurinol therapy, compared with lower adherence level (< 80%), was associated with a lower rate of ESRD onset (RR = 0.35; 95%CI: 0.13-0.91).

CONCLUSION

Gout control seem to be associated with a significant decreased risk of ESRD onset in hypertensive populations, further research should be conducted confirming this potential associated risk.

摘要

目的

确定别嘌醇治疗依从性不佳作为疾病控制不佳的指标对终末期肾病（ESRD）一级预防的影响。

方法

利用魁北克省医疗保险局和MedEcho管理数据库重建了一组2752例痛风诊断患者。符合条件的患者为别嘌醇新使用者，年龄在45 - 85岁之间，诊断为高血压，并在1997年至2007年期间接受抗高血压药物治疗。

结果

ESRD发病的主要危险因素是1至3期慢性肾病[率比（RR）= 8.00；95%置信区间（CI）：3.16 - 22.3]，高血压的严重程度（≥3种与<3种抗高血压药物）作为粗略估计是一个有趋势的危险因素（RR = 1.94；95%CI：0.68 - 5.51）。在341例患者中，病例组（n = 22）和对照组（n = 319），与较低依从水平（<80%）相比，别嘌醇治疗的高依从水平（≥80%）与ESRD发病较低的发生率相关（RR = 0.35；95%CI：0.13 - 0.91）。