Department of Nephrology, Zhongshan Hospital Xiamen University, Xiamen.
Department of Nephrology, Lichuan People's Hospital, Lichuan, China.
Medicine (Baltimore). 2021 Mar 12;100(10):e24616. doi: 10.1097/MD.0000000000024616.
Major adverse cardiac and cerebral events (MACCE) are common complications, which prolong hospitalization and increase mortality rate in end-stage renal disease (ESRD) patients who underwent continuous ambulatory peritoneal dialysis (CAPD). Therefore, this study aimed to investigate MACCE occurrence and its potential predictive factors in those patients.In this prospective cohort study, 196 diagnosis of ESRD patients who underwent CAPD treatment in our hospital were eligible, and their clinical data (including demographic data and biochemical indexes) were documented. Besides, their MACCE occurrence was assessed within 3-year follow-up period.In patients, 1-, 2-, and 3-year MACCE occurrence rates were 5.1%, 11.7%, and 14.8%, respectively. Meanwhile, the mean duration of accumulating MACCE occurrence was 33.1 (95% confidence interval: 32.0-34.2) months. Furthermore, age, peritoneal dialysis duration (PDD), C-reactive protein (CRP), fasting blood glucose (FBG) and total cholesterol high correlated with increased accumulating MACCE occurrence, while high-density lipoprotein cholesterol (HDL-C) high correlated with decreased accumulating MACCE occurrence. Notably, by further multivariate Cox's proportional hazard regression analysis, age, PDD, CRP, serum uric acid, and FBG high were independent predictive factors for raised accumulating MACCE occurrence, while HDL-C high was an independent predictive factor for attenuated accumulating MACCE occurrence.MACCE are common; besides, age, peritoneal dialysis duration, C-reactive protein, serum uric acid, fasting blood glucose, and high-density lipoprotein cholesterol serve as potential markers for indicating MACCE in ESRD patients who underwent CAPD.
主要不良心脑事件(MACCE)是常见的并发症,会延长终末期肾病(ESRD)患者的住院时间并增加其死亡率,这些患者接受了持续不卧床腹膜透析(CAPD)治疗。因此,本研究旨在探讨这些患者 MACCE 的发生及其潜在的预测因素。
在这项前瞻性队列研究中,纳入了 196 名在我院接受 CAPD 治疗的 ESRD 患者,记录了他们的临床数据(包括人口统计学数据和生化指标)。此外,还评估了他们在 3 年随访期间的 MACCE 发生情况。
在这些患者中,1 年、2 年和 3 年的 MACCE 发生率分别为 5.1%、11.7%和 14.8%。同时,MACCE 累计发生的平均持续时间为 33.1 个月(95%置信区间:32.0-34.2)。此外,年龄、腹膜透析持续时间(PDD)、C 反应蛋白(CRP)、空腹血糖(FBG)和总胆固醇与累积 MACCE 发生率的增加相关,而高密度脂蛋白胆固醇(HDL-C)与累积 MACCE 发生率的降低相关。值得注意的是,通过进一步的多变量 Cox 比例风险回归分析,年龄、PDD、CRP、血清尿酸和 FBG 升高是累积 MACCE 发生率升高的独立预测因素,而 HDL-C 升高是累积 MACCE 发生率降低的独立预测因素。
MACCE 很常见;此外,年龄、腹膜透析持续时间、C 反应蛋白、血清尿酸、空腹血糖和高密度脂蛋白胆固醇可作为预测 CAPD 治疗的 ESRD 患者 MACCE 的潜在标志物。