肾移植等待名单上年轻患者的高心血管风险状况

Mülling Nils, Kallenberg Nico, Benson Sven, Dolff Sebastian, Kribben Andreas, Reinhardt Walter

Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.

Transplant Proc. 2019 Jul-Aug;51(6):1717-1726. doi: 10.1016/j.transproceed.2019.04.055. Epub 2019 Jul 10.

BACKGROUND

Cardiovascular complications are the leading causes of morbidity and mortality in patients with end-stage renal disease. The risk profile very often contributes to their death while on the waiting list. Most studies have been carried out in older patients with end-stage renal disease, reflecting the general dialysis population. The aim of this study was to analyze the risk profile in young patients with advanced chronic kidney disease on the kidney transplant waiting list.

METHODS

This was a retrospective, single-center study of 748 patients on the kidney transplant waiting list at the University Hospital Essen, Germany. Clinical and laboratory parameters were collected between 2015 and 2016.

RESULTS

Of 748 patients (62% male), the median age was 48 years. Hypertension, coronary heart disease, and diabetes mellitus were the leading comorbidities, and their frequency rose significantly with age. Their median laboratory values did not differ significantly depending on age except for albumin. Hyperuricemia was quite common in our population with a prevalence of about 75% in women and 50% in men throughout all age groups. A total of 26.6% of the patients between 18 and 35 years of age had advanced anemia (hemoglobin < 10 g/dL), and thus they were affected most frequently. Elevated C-reactive protein serum levels were observed in 37.2% of the patients. Regarding the lipid profile, we observed that HDL cholesterol was within the normal range in only among 51.9% of men and 44.3% of women.

CONCLUSIONS

Cardiovascular risk factors are quite common in our cohort and affect young patients similarly.

背景

心血管并发症是终末期肾病患者发病和死亡的主要原因。风险特征常常导致他们在等待名单上时死亡。大多数研究是在老年终末期肾病患者中进行的，反映了一般透析人群。本研究的目的是分析肾移植等待名单上的年轻晚期慢性肾病患者的风险特征。

方法

这是一项对德国埃森大学医院748名肾移植等待名单上患者的回顾性单中心研究。2015年至2016年期间收集了临床和实验室参数。

结果

748名患者（62%为男性）的中位年龄为48岁。高血压、冠心病和糖尿病是主要的合并症，其发生率随年龄显著上升。除白蛋白外，他们的中位实验室值在不同年龄组之间无显著差异。高尿酸血症在我们的人群中相当常见，在所有年龄组中女性患病率约为75%，男性为50%。18至35岁的患者中共有26.6%患有重度贫血（血红蛋白<10g/dL），因此他们受影响最为频繁。37.2%的患者血清C反应蛋白水平升高。关于血脂情况，我们观察到只有51.9%的男性和44.3%的女性高密度脂蛋白胆固醇在正常范围内。