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他汀类药物的使用与肾功能正常的高胆固醇血症患者慢性肾脏病的发生。

Statin Use and Incidence of Chronic Kidney Disease in Hypercholesterolemia Patients with Normal Renal Function.

机构信息

Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.

Department of Information and Statistics, Chungbuk National University, Cheongju, Republic of Korea.

出版信息

Am J Nephrol. 2021;52(12):940-948. doi: 10.1159/000520532. Epub 2021 Dec 3.

Abstract

INTRODUCTION

Dyslipidemia is a known risk factor for chronic kidney disease (CKD). The effects of statins on CKD have already been studied in patients with CKD; however, data on the general population are limited. This study aimed to determine the relationship between statin use and the incidence of CKD in patients with hypercholesterolemia having normal renal function.

METHODS

A total of 7,856 participants aged 40-79 years at baseline (2009-2010) were included in the final analyses. The participants were divided into statin users (n = 4,168) and statin nonusers (n = 3,668), according to the statin usage. The Cox proportional hazard regression model was used to evaluate the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for CKD.

RESULTS

The median follow-up duration was 5.8 years. A total of 543 cases of CKD (285 cases in males and 258 cases in females) occurred during the study period. The estimated cumulative incidence of CKD was significantly different between male statin nonusers and users (p < 0.001), while it was not statistically significant between female statin nonusers and users (p = 0.126). Compared with statin nonusers, the fully adjusted HRs (95% CIs) for CKD in statin users were 1.014 (0.773-1.330) in males and 1.117 (0.843-1.481) in females.

CONCLUSION

Dyslipidemia is an obvious risk factor for CKD; however, statin use in patients with hypercholesterolemia having normal renal function does not demonstrate a clear relationship with the incidence of CKD.

摘要

简介

血脂异常是慢性肾脏病(CKD)的已知危险因素。他汀类药物对 CKD 的影响已在 CKD 患者中进行了研究;然而,关于普通人群的数据有限。本研究旨在确定在肾功能正常的高胆固醇血症患者中,使用他汀类药物与 CKD 发生率之间的关系。

方法

共有 7856 名年龄在 40-79 岁的参与者在基线(2009-2010 年)进入最终分析。根据他汀类药物的使用情况,将参与者分为他汀类药物使用者(n=4168)和他汀类药物非使用者(n=3668)。使用 Cox 比例风险回归模型评估 CKD 的调整后危险比(HR)及其 95%置信区间(CI)。

结果

中位随访时间为 5.8 年。在研究期间共发生 543 例 CKD(男性 285 例,女性 258 例)。男性他汀类药物非使用者和使用者之间的 CKD 累积发生率差异具有统计学意义(p<0.001),而女性他汀类药物非使用者和使用者之间的差异无统计学意义(p=0.126)。与他汀类药物非使用者相比,他汀类药物使用者的 CKD 全调整 HR(95%CI)在男性为 1.014(0.773-1.330),在女性为 1.117(0.843-1.481)。

结论

血脂异常是 CKD 的明显危险因素;然而,在肾功能正常的高胆固醇血症患者中使用他汀类药物与 CKD 的发生率之间没有明确的关系。

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