Renal Research Institute, New York, New York, USA.
Fresenius Medical Care, Bad Homburg, Germany.
Blood Purif. 2018;45(1-3):245-253. doi: 10.1159/000485162. Epub 2018 Jan 26.
Tall people have improved metabolic profiles and better cardiovascular outcomes, a relationship inverted in dialysis patients. We investigated the relationship between height and outcomes in incident hemodialysis (HD) patients commencing treatment in an analysis of the international Monitoring Dialysis Outcomes (MONDO) database.
In this retrospective cohort study, we included incident HD patients commencing treatment between -January 1, 2006 and December 31, 2010 and investigated the association between height and mortality using the MONDO database. A 6-months baseline period preceded 2.5 years of follow-up, during which we recorded patient mortality. Patients were stratified in region-specific deciles of the respective database's population (Asia Pacific, North and South America, and Europe) and we developed Cox-proportional hazard models (additionally adjusted for age, gender, post-dialysis weight, eKt/V, albumin, interdialytic weight gain, phosphorus, and predialysis systolic blood pressure) for each database.
We studied 23,353 patients (62 ± 15 years old, 42% female, body mass index 26 ± 6 kg/m2, height 165 ± 10 cm). We found a trend of increasing hazard ratio of death (HR) with increasing height for Asia Pacific, Europe, and South America. In the fully adjusted models, for South America, we found a trend of increasing HR without significance among deciles >5. In Europe, deciles 8-10 had significantly increased HR. No clear trend was found in North America.
We found an increasing risk of death with increasing height in all regions, except North America. While the reasons remain unclear, further research may be warranted.
高个子人群的代谢指标和心血管预后更好，但这种关系在透析患者中则相反。我们通过对国际监测透析结局（MONDO）数据库的分析，研究了起始血液透析（HD）患者的身高与结局之间的关系。
在这项回顾性队列研究中，我们纳入了 2006 年 1 月 1 日至 2010 年 12 月 31 日期间起始 HD 治疗的患者，并利用 MONDO 数据库调查了身高与死亡率之间的关系。在 2.5 年的随访前，有 6 个月的基线期，在此期间我们记录了患者的死亡率。患者按各自数据库人群的特定地区（亚太地区、北美和南美以及欧洲）的 10 个等分位数分层，我们为每个数据库开发了 Cox 比例风险模型（另外还根据年龄、性别、透析后体重、eKt/V、白蛋白、透析间体重增加、磷和透析前收缩压进行了调整）。
我们研究了 23353 名患者（62 ± 15 岁，42%为女性，体重指数 26 ± 6 kg/m2，身高 165 ± 10 cm）。我们发现，对于亚太地区、欧洲和南美，死亡风险比（HR）随着身高的增加而呈上升趋势。在完全调整的模型中，对于南美，我们发现 HR 随着身高的增加而呈上升趋势，但没有统计学意义。在欧洲，第 8-10 个等分位数的 HR 显著增加。在北美没有发现明显的趋势。
我们发现，除了北美以外，所有地区的死亡风险都随着身高的增加而增加。虽然原因尚不清楚，但可能需要进一步研究。
