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[脑钠肽预测接受治疗的终末期肾病患者心血管疾病死亡率]

[BNP predicts mortality of cardiovascular disease in patients with end-stage renal disease treated].

作者信息

Álvarez-Aguilar Cleto, Arroyo-Ramírez Esmirna, Gómez-García Anel, Alvarez-Paredes Alfonso Rafael, Rodríguez-Orozco Alain R, Flores-Guajardo Gonzalo, Rangel-López Angélica

机构信息

Hospital General Regional No. 1, Instituto Mexicano del Seguro Social, Morelia, Michoacán de Ocampo, México Correo electrónico:

出版信息

Rev Med Inst Mex Seguro Soc. 2017;55(Suppl 2):S158-66.

Abstract

BACKGROUND

Mortality for cardiovascular disease (CVD) in patients with chronic kidney disease (CKD) is higher. In the end-stage renal disease (ESRD) the mortality is 20 times greater in comparison with general population. Natriuretic peptides, particularly type-B natriuretic peptide (BNP) have been studied as potential markers of risk of cardiovascular (CV) mortality. The aim of this paper is to determine whether BNP acts as a prognostic marker for CV mortality in patients with ESRD.

METHODS

We studied 53 patients with ESRD prevalent in peritoneal dialysis without clinical evidence of heart failure at baseline was studied. The impact of variables was performed with linear regression model. The probability of survival was estimated by Kaplan-Meir analysis and the difference between survivals between groups with log-rank test according the levels of BNP. Adjusted hazard ratios were calculated with Cox proportional hazards analysis.

RESULTS

BNP strongly predicts CVD mortality. The Cox regression model showed that BNP is a predictor of death from CVD. Patients with high levels of BNP were at increased risk of death. Several pathophysiological mechanisms not well defined are involved.

CONCLUSIONS

BNP predicts CVD mortality in patients with ESRD. Serum measurement of this peptide can be useful for risk stratification in these patients and adjust treatment.

摘要

背景

慢性肾脏病(CKD)患者心血管疾病(CVD)的死亡率更高。在终末期肾病(ESRD)中,其死亡率相较于普通人群高出20倍。利钠肽,尤其是B型利钠肽(BNP)已被作为心血管(CV)死亡风险的潜在标志物进行研究。本文旨在确定BNP是否可作为ESRD患者CV死亡的预后标志物。

方法

我们研究了53例接受腹膜透析的ESRD患者,这些患者在基线时无心力衰竭的临床证据。采用线性回归模型分析变量的影响。通过Kaplan-Meir分析估计生存概率,并根据BNP水平用对数秩检验比较组间生存率差异。采用Cox比例风险分析计算调整后的风险比。

结果

BNP能有力地预测CVD死亡率。Cox回归模型显示BNP是CVD死亡的预测因子。BNP水平高的患者死亡风险增加。其中涉及一些尚未明确的病理生理机制。

结论

BNP可预测ESRD患者的CVD死亡率。检测该肽的血清水平有助于对这些患者进行风险分层并调整治疗方案。

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