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常染色体显性遗传性多囊肾病血液透析患者血管通路的预后。

Prognosis of Vascular Access in Haemodialysis Patients with Autosomal Dominant Polycystic Kidney Disease.

机构信息

School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

出版信息

Sci Rep. 2020 Feb 6;10(1):1985. doi: 10.1038/s41598-020-58441-5.

Abstract

Vascular diseases are commonly observed in patients with autosomal dominant polycystic kidney disease (ADPKD). We aim to investigate the differences in the risk for arteriovenous fistula or graft (AVF/AVG) dysfunction in haemodialysis (HD) patients with and without ADPKD. 557 ADPKD and 1671 non-ADPKD patients were enrolled in the study after propensity score matching. The primary outcome measure is the incidence rate of AVF/AVG dysfunction. The incidence rates and risks of AVF/AVG dysfunction (per 100 person-years) for ADPKD and non-ADPKD patients were (1) 38.83 and 48.99 [SHR = 0.79, P = 0.137], respectively, for within 90 days, (2) 45.85 and 51.31 [SHR = 0.90, P = 0.300], respectively, for within 180 days, (3) 44.42 and 41.40 [SHR = 1.08, P = 0.361], respectively, for within the first year, (4) 27.38 and 24.69 [SHR = 1.09, P = 0.168], respectively, for within 5 years, (5) 17.35 and 13.80 [SHR = 1.19, P = 0.045], respectively, for between the 1st and 10th year, and (6) 25.40 and 21.22 [SHR = 1.14, P = 0.031], respectively, for all periods. ADPKD patients had lower incidence rates of AVF/AVG dysfunction within the first 180 days than non-ADPKD patients, but presented a higher incidence rate after 1 year of AVF/AVG creation and onwards.

摘要

血管疾病在常染色体显性多囊肾病 (ADPKD) 患者中较为常见。我们旨在研究血液透析 (HD) 患者中存在和不存在 ADPKD 时动静脉瘘或移植物 (AVF/AVG) 功能障碍的风险差异。通过倾向评分匹配后,共纳入 557 例 ADPKD 和 1671 例非 ADPKD 患者进行研究。主要结局指标是 AVF/AVG 功能障碍的发生率。ADPKD 和非 ADPKD 患者的 AVF/AVG 功能障碍(每 100 人年)发生率和风险分别为:(1) 90 天内为 38.83%和 48.99%(SHR=0.79,P=0.137);(2) 180 天内为 45.85%和 51.31%(SHR=0.90,P=0.300);(3) 1 年内为 44.42%和 41.40%(SHR=1.08,P=0.361);(4) 5 年内为 27.38%和 24.69%(SHR=1.09,P=0.168);(5) 10 年内为 17.35%和 13.80%(SHR=1.19,P=0.045);(6) 所有时期为 25.40%和 21.22%(SHR=1.14,P=0.031)。与非 ADPKD 患者相比,ADPKD 患者在 AVF/AVG 建立后 180 天内的 AVF/AVG 功能障碍发生率较低,但在 1 年后及以后,其发生率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97de/7004976/5d4e7fb9d908/41598_2020_58441_Fig1_HTML.jpg

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