Department of Nephrology, Level 2, ARTS Building, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD, 4102, Australia.
School of Medicine, University of Queensland, Brisbane, Australia.
BMC Nephrol. 2021 Dec 2;22(1):401. doi: 10.1186/s12882-021-02604-7.
Cardiovascular disease is a leading cause of mortality in kidney failure (KF). Patients with KF from atheroembolic disease are at higher risk of cardiovascular disease than other causes of KF. This study aimed to determine survival on dialysis for patients with KF from atheroembolic disease compared with other causes of KF.
All adults (≥ 18 years) with KF initiating dialysis as the first kidney replacement therapy between 1 January 1990 and 31 December 2017 according to the Australia and New Zealand Dialysis and Transplant registry were included. Patients were grouped into either: KF from atheroembolic disease and all other causes of KF. Survival outcomes were assessed by the Kaplan-Meier method and Cox regression analysis adjusted for patient-related characteristics.
Among 65,266 people on dialysis during the study period, 334 (0.5%) patients had KF from atheroembolic disease. A decreasing annual incidence of KF from atheroembolic disease was observed from 2008 onwards. Individuals with KF from atheroembolic disease demonstrated worse survival on dialysis compared to those with other causes of KF (HR 1.80, 95% confidence interval [CI] 1.61-2.03). The respective one- and five-year survival rates were 77 and 23% for KF from atheroembolic disease and 88 and 47% for other causes of KF. After adjustment for patient characteristics, KF from atheroembolic disease was not associated with increased patient mortality (adjusted HR 0.93 95% CI 0.82-1.05).
Survival outcomes on dialysis are worse for individuals with KF from atheroembolic disease compared to those with other causes of KF, probably due to patient demographics and higher comorbidity.
心血管疾病是肾衰竭（KF）患者死亡的主要原因。与其他原因导致的 KF 相比，动脉栓塞性疾病导致的 KF 患者发生心血管疾病的风险更高。本研究旨在比较动脉栓塞性疾病与其他原因导致的 KF 患者在透析治疗中的生存率。
所有于 1990 年 1 月 1 日至 2017 年 12 月 31 日期间根据澳大利亚和新西兰透析和移植登记处开始透析作为首次肾脏替代治疗的成年人（≥18 岁）均纳入本研究。患者分为：动脉栓塞性疾病导致的 KF 和其他所有原因导致的 KF。通过 Kaplan-Meier 法和 Cox 回归分析评估生存结局，并对患者相关特征进行调整。
在研究期间接受透析治疗的 65266 人中，有 334 例（0.5%）患有动脉栓塞性疾病导致的 KF。自 2008 年以来，动脉栓塞性疾病导致的 KF 年发病率呈下降趋势。与其他原因导致的 KF 患者相比，动脉栓塞性疾病导致的 KF 患者在透析治疗中的生存情况更差（HR 1.80，95%置信区间[CI] 1.61-2.03）。动脉栓塞性疾病导致的 KF 的 1 年和 5 年生存率分别为 77%和 23%，其他原因导致的 KF 的 1 年和 5 年生存率分别为 88%和 47%。在调整患者特征后，动脉栓塞性疾病导致的 KF 与患者死亡率增加无关（调整 HR 0.93，95%CI 0.82-1.05）。
与其他原因导致的 KF 患者相比，动脉栓塞性疾病导致的 KF 患者在透析治疗中的生存结局更差，这可能与患者的人口统计学特征和更高的合并症发生率有关。
