心-踝血管指数对终末期肾病风险的预测价值。
Predictive value of cardio-ankle vascular index for the risk of end-stage renal disease.
作者信息
Jeong Jin Seon, Kim Jung Hee, Kim Dong Ki, Oh Kook-Hwan, Joo Kwon-Wook, Kim Yon Su, Cho Young Min, Han Seung Seok
机构信息
Division of Nephrology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
出版信息
Clin Kidney J. 2020 Jul 28;14(1):255-260. doi: 10.1093/ckj/sfaa116. eCollection 2021 Jan.
BACKGROUND
Arterial stiffness is associated with increased cardiovascular morbidity and mortality. However, the predictive value of the cardio-ankle vascular index (CAVI), one of the indicators for arterial stiffness, for the risk of end-stage renal disease (ESRD) remains unknown.
METHODS
A total of 8701 patients with documented CAVI measurements by pulse wave velocity (PWV) were included in the study. Patients were divided according to the quartiles of CAVI. The hazard ratio (HR) of ESRD was calculated using the Cox model, after adjustment for multiple variables or death.
RESULTS
During the median follow-up period of 7 years (maximum 12 years), ESRD and mortality occurred in 203 and 1071 patients, respectively. The median value of CAVI was 8.5 (interquartile range 7.7-9.3). The risk of ESRD was higher in the fourth-quartile group than the first-quartile group [adjusted HR 2.46 (IQR 1.62-3.71), P<0.001]. When a death-adjusted risk analysis was performed, the fourth quartile of CAVI had a higher risk of ESRD than the first quartile [adjusted HR 2.35 (IQR 1.58-3.49), P<0.001].
CONCLUSIONS
The measurement of CAVI by PWV may be needed to predict the risk of ESRD.
背景
动脉僵硬度与心血管疾病发病率和死亡率的增加相关。然而，作为动脉僵硬度指标之一的心脏-脚踝血管指数（CAVI）对终末期肾病（ESRD）风险的预测价值仍不清楚。
方法
本研究共纳入8701例通过脉搏波速度（PWV）测量CAVI的患者。根据CAVI的四分位数对患者进行分组。在对多个变量或死亡进行调整后，使用Cox模型计算ESRD的风险比（HR）。
结果
在中位随访期7年（最长12年）内，分别有203例和1071例患者发生ESRD和死亡。CAVI的中位数为8.5（四分位间距7.7 - 9.3）。第四四分位组的ESRD风险高于第一四分位组[调整后HR 2.46（四分位间距1.62 - 3.71），P<0.001]。当进行死亡调整风险分析时，CAVI的第四四分位组发生ESRD的风险高于第一四分位组[调整后HR 2.35（四分位间距1.58 - 3.49），P<0.001]。
结论
可能需要通过PWV测量CAVI来预测ESRD风险。
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