Morooka Hikaru, Tanaka Akihito, Inaguma Daijo, Maruyama Shoichi
Departmnt of Nephrology, Nagoya University Hospital, Nagoya, Aichi, Japan.
Departmnt of Nephrology, Nagoya University Hospital, Nagoya, Aichi, Japan
BMJ Open. 2020 Dec 31;10(12):e042315. doi: 10.1136/bmjopen-2020-042315.
Patients with peripheral artery disease (PAD) are reported to have a poorer prognosis than those without PAD. PAD is sometimes found at dialysis initiation, but its influence on the prognosis in these patients has not been investigated. We aimed to compare the mortality rate between patients with PAD at the time of dialysis initiation and those without PAD.
We undertook an observational prospective multicenter study of patients starting dialysis treatment. Data were collected on patients' sex, age, presence of PAD, medication, medical history and clinical and laboratory data.
Seventeen centers participated in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis.
A total of 1524 patients with chronic kidney disease started dialysis from October 2011 to September 2013. The patients were followed-up until March 2015. During this time, there were two patients who lost the follow-up.
The primary outcome was defined as all-cause mortality. The secondary outcomes were defined as each cause of mortality.
This study included 1030 men and 492 women with a mean age of 67.50±13.10 years. Of these, 71 had PAD and 1451 did not have PAD. After a median follow-up of 814.5 days, 33.80% of the former group and 17.00% of the latter group had died in March 2015 (p=0.001). After adjusting for confounding factors, PAD at dialysis initiation remained an independent risk factor for mortality (p<0.01).
Patients with PAD at the time of dialysis initiation had a poorer prognosis than patients without PAD. Therefore, the presence of PAD in patients starting dialysis should be considered for their monitoring and follow-up.
据报道，外周动脉疾病（PAD）患者的预后比无PAD患者更差。有时在开始透析时发现PAD，但尚未研究其对这些患者预后的影响。我们旨在比较开始透析时患有PAD的患者与无PAD患者的死亡率。
我们对开始透析治疗的患者进行了一项观察性前瞻性多中心研究。收集了患者的性别、年龄、PAD的存在情况、用药情况、病史以及临床和实验室数据。
17个中心参与了爱知县新开始透析患者预后队列研究。
2011年10月至2013年9月，共有1524例慢性肾脏病患者开始透析。对这些患者进行随访直至2015年3月。在此期间，有2例患者失访。
主要结局定义为全因死亡率。次要结局定义为每种死亡原因。
本研究包括1030名男性和492名女性，平均年龄为67.50±13.10岁。其中，71例患有PAD，1451例未患有PAD。在中位随访814.5天后，前一组中有33.80%的患者在2015年3月死亡，后一组中有17.（此处原文有误，应为17.00%）0%的患者死亡（p = 0.001）。在调整混杂因素后，开始透析时的PAD仍然是死亡率的独立危险因素（p < 0.01）。
开始透析时患有PAD的患者预后比无PAD的患者更差。因此，对于开始透析的患者，应考虑其是否存在PAD以进行监测和随访。
