分析 2897 例慢性肾脏病患者住院事件：来自 CKD-JAC 研究的结果。
Analysis of 2897 hospitalization events for patients with chronic kidney disease: results from CKD-JAC study.
机构信息
Teikyo Academic Research Center, Teikyo University, 2-11-1, Kaga, Itabashi-ku, Tokyo, Japan.
Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Bunkyo-ku, Tokyo, Japan.
出版信息
Clin Exp Nephrol. 2019 Jul;23(7):956-968. doi: 10.1007/s10157-019-01730-9. Epub 2019 Apr 9.
BACKGROUND
Chronic kidney disease is a known risk factor for end-stage renal and cardiovascular diseases. However, data are limited on the causes of hospitalization in patients with chronic kidney disease of maintenance period. This study aimed to aggregate hospitalization data of CKD patients and to determine the high-risk population. In addition, we compared CKD population to general population.
METHODS
We conducted a post hoc analysis of the chronic kidney disease-Japan cohort study, a multicenter prospective cohort study of 2966 patients with chronic kidney disease with a median 3.9 years of follow-up. We examined the hospitalization reasons and analyzed the risk factors.
RESULTS
We found 2897 all-cause hospitalization events (252.3 events/1000 person-years), a hospitalization incidence 17.1-fold higher than that in an age- and sex-matched cohort from the general Japanese population. Kidney, eye and adnexa, and heart-related hospital admissions were the most common. All-cause hospitalization increased with chronic kidney disease stage and with the presence of diabetes. Patients with diabetes at enrollment had 345.7 hospitalization events/1000 person-years, which is considerably higher than 196.8 events/1000 person-years for those without diabetes. Survival analysis, using hospitalization as an event, showed earlier all-cause hospitalization with the progression of chronic kidney disease stage and diabetes. Cardiovascular disease hospitalizations were more strongly influenced by diabetes than chronic kidney disease stage.
CONCLUSIONS
Patients with chronic kidney disease and diabetes are highly vulnerable to hospitalization for a variety of diseases. These descriptive data can be valuable in predicting the prognosis of patients with chronic kidney disease.
背景
慢性肾脏病是终末期肾脏和心血管疾病的已知危险因素。然而，关于维持期慢性肾脏病患者住院的原因的数据有限。本研究旨在汇总慢性肾脏病患者的住院数据，并确定高危人群。此外，我们将慢性肾脏病患者与一般人群进行了比较。
方法
我们对慢性肾脏病-日本队列研究进行了事后分析，该研究是一项针对 2966 例慢性肾脏病患者的多中心前瞻性队列研究，中位随访时间为 3.9 年。我们检查了住院原因，并分析了危险因素。
结果
我们发现了 2897 例全因住院事件（252.3 例/1000 人年），住院发生率是年龄和性别匹配的一般日本人群的 17.1 倍。肾脏、眼睛和附属器以及心脏相关的住院治疗是最常见的。全因住院率随着慢性肾脏病分期的增加和糖尿病的存在而增加。入组时患有糖尿病的患者全因住院事件数为 345.7 例/1000 人年，明显高于无糖尿病患者的 196.8 例/1000 人年。以住院为事件的生存分析显示，随着慢性肾脏病分期和糖尿病的进展，全因住院时间更早。与慢性肾脏病分期相比，心血管疾病住院更多地受到糖尿病的影响。
结论
患有慢性肾脏病和糖尿病的患者极易因各种疾病住院。这些描述性数据对于预测慢性肾脏病患者的预后具有重要价值。
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