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韩国慢性肾脏病患者心血管事件及死亡率

Incidence of cardiovascular events and mortality in Korean patients with chronic kidney disease.

作者信息

Ryu Hyunjin, Kim Jayoun, Kang Eunjeong, Hong Yeji, Chae Dong-Wan, Choi Kyu Hun, Han Seung Hyeok, Yoo Tae Hyun, Lee Kyubeck, Kim Yong-Soo, Chung Wookyung, Oh Yun Kyu, Kim Soo Wan, Kim Yeong Hoon, Sung Su Ah, Lee Joongyub, Park Sue K, Ahn Curie, Oh Kook-Hwan

机构信息

Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea.

出版信息

Sci Rep. 2021 Jan 13;11(1):1131. doi: 10.1038/s41598-020-80877-y.

Abstract

Few studies have investigated the incidence of cardiovascular disease (CVD) in the Asian chronic kidney disease (CKD) population. This study assessed the incidence of CVD, death, and a composite outcome of CVD and death in a prospective Korean predialysis CKD cohort. From a total of 2179 patients, incidence rates were analyzed, and competing risk analyses were conducted according to CKD stage. Additionally, incidence was compared to the general population. During a median 4.1 years of follow-up, the incidence of CVD, all-cause death, and the composite outcome was 17.2, 9.6, and 24.5 per 1000 person-years, respectively. These values were higher in diabetic vs. non-diabetic subjects (P < 0.001). For all outcomes, incidence rates increased with increasing CKD stage (CVD, P = 0.001; death, P < 0.001; and composite, P < 0.001). Additionally, CKD stage G4 [hazard ratio (HR) 2.8, P = 0.008] and G5 (HR 5.0, P < 0.001) were significant risk factors for the composite outcome compared to stage G1 after adjustment. Compared to the general population, the total cohort population (stages G1-G5) showed significantly higher risk of CVD (HR 2.4, P < 0.001) and the composite outcome (HR 1.7, P < 0.001). The results clearly demonstrate that CKD is a risk factor for CVD in an Asian population.

摘要

很少有研究调查亚洲慢性肾脏病(CKD)人群中心血管疾病(CVD)的发病率。本研究评估了韩国一个前瞻性透析前CKD队列中CVD、死亡以及CVD和死亡的复合结局的发病率。对总共2179例患者的发病率进行了分析,并根据CKD分期进行了竞争风险分析。此外,还将发病率与普通人群进行了比较。在中位4.1年的随访期间,CVD、全因死亡和复合结局的发病率分别为每1000人年17.2、9.6和24.5。糖尿病患者与非糖尿病患者的这些值更高(P<0.001)。对于所有结局,发病率均随CKD分期的增加而升高(CVD,P=0.001;死亡,P<0.001;复合结局,P<0.001)。此外,调整后,与G1期相比,CKD G4期[风险比(HR)2.8,P=0.008]和G5期(HR 5.0,P<0.001)是复合结局的显著危险因素。与普通人群相比,整个队列人群(G1-G5期)的CVD风险(HR 2.4,P<0.001)和复合结局风险(HR 1.7,P<0.001)显著更高。结果清楚地表明,CKD是亚洲人群CVD的一个危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe77/7806882/cd412a893b64/41598_2020_80877_Fig1_HTML.jpg

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