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常染色体显性多囊肾病患者贫血与肾脏预后的关系:一项回顾性研究。

Association between anemia and renal prognosis in autosomal dominant polycystic kidney disease: a retrospective study.

机构信息

Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Clinical Research Division for Polycystic Kidney Disease, Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Clin Exp Nephrol. 2020 Jun;24(6):500-508. doi: 10.1007/s10157-020-01856-1. Epub 2020 Feb 8.

DOI:10.1007/s10157-020-01856-1
PMID:32036465
Abstract

BACKGROUND

Though anemia is a sign of poor renal prognosis in chronic kidney disease (CKD), hemoglobin (Hb) levels are typically higher in autosomal dominant polycystic kidney disease (ADPKD) than in other kidney diseases, and anemia has not been examined as a potential prognosticator. Thus, we investigated anemia as a factor for renal prognosis in ADPKD.

METHODS

In total, 115 non-dialysis patients, 48 men and 67 women, with ADPKD were evaluated. The renal outcome of a 50% reduction in the estimated glomerular filtration rate or renal replacement therapy was examined using the Cox regression analysis and Kaplan-Meier analysis.

RESULTS

Patients were followed for a median of 5.5 years and 50 patients had reached the end point. The mean age of the patients at the first visit was 45.9 ± 13.3 years. The overall mean Hb was 12.90 ± 1.85 g/dL, and the mean Hb in men and women was 13.82 ± 1.72 g/dL and 12.25 ± 1.65 g/dL, respectively. Hb levels and uric protein content were statistically significant factors for poor renal prognosis, while hypertension and genetic mutations failed to reach significance. Furthermore, statistical significance was found in men with Hb < 12 g/dL and in women with Hb < 11 g/dL. Anemia had significant association with kidney disease progression in patients with ADPKD.

CONCLUSIONS

We found that anemia might be a factor for poor renal prognosis in ADPKD. Furthermore, a sex difference was found, wherein men with Hb < 12 g/dL and women with Hb < 11 g/dL were at risk of renal disease progression.

摘要

背景

尽管贫血是慢性肾脏病(CKD)肾功能预后不良的一个标志,但常染色体显性多囊肾病(ADPKD)患者的血红蛋白(Hb)水平通常高于其他肾脏疾病,且贫血尚未被视为潜在的预后预测因素。因此,我们研究了贫血是否是 ADPKD 患者肾脏预后的一个因素。

方法

共评估了 115 例非透析 ADPKD 患者(48 名男性和 67 名女性)。使用 Cox 回归分析和 Kaplan-Meier 分析检查肾小球滤过率降低 50%或需要肾脏替代治疗的肾脏结局。

结果

患者中位随访 5.5 年,50 例患者达到终点。首次就诊时患者的平均年龄为 45.9±13.3 岁。所有患者的平均总 Hb 为 12.90±1.85 g/dL,男性和女性的平均 Hb 分别为 13.82±1.72 g/dL 和 12.25±1.65 g/dL。Hb 水平和尿蛋白含量是不良肾功能预后的统计学显著因素,而高血压和基因突变未达到显著水平。此外,在 Hb<12 g/dL 的男性和 Hb<11 g/dL 的女性中发现了统计学意义。贫血与 ADPKD 患者的肾脏疾病进展有显著关联。

结论

我们发现贫血可能是 ADPKD 患者肾功能不良预后的一个因素。此外,还发现了性别差异,Hb<12 g/dL 的男性和 Hb<11 g/dL 的女性有肾脏疾病进展的风险。

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