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慢性肾脏病中的非传统风险因素:肌酐清除率、弗雷明汉风险评分、内皮功能障碍与炎症之间的相关性

Nontraditional risk factors in chronic kidney disease: correlation between creatinine clearance, Framingham risk score, endothelial dysfunction, and inflammation.

作者信息

Tawfik Ahmed Mohamed, Tawfik Heba Mohamed

机构信息

Internal Medicine & Nephrology department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

Geriatrics & Gerontology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

出版信息

Egypt J Intern Med. 2022;34(1):29. doi: 10.1186/s43162-022-00110-2. Epub 2022 Mar 14.

Abstract

BACKGROUND

Chronic kidney disease became a public health problem increasing healthcare burden. Our aim was to detect the relationship between cardiovascular risk, endothelial dysfunction, inflammation, and kidney function in chronic kidney disease patients and to detect the nontraditional factors affecting the decline in kidney functions.

METHODS

A cross-sectional study including 30 male and female patients with chronic kidney disease stages 3-5. Creatinine clearance and Framingham risk score points were calculated. Carotid intimal medial thickness was measured as well as absolute flow mediated dilatation in brachial artery. Highly sensitive C-reactive protein, parathyroid hormone, kidney function tests, and lipid profile were measured.

RESULTS

Framingham risk score points and carotid intimal medial thickness increased significantly with decreasing creatinine clearance ( 0.0025, 0.0285) respectively. A significant correlation was found between highly sensitive C-reactive protein and Framingham risk score points but not with carotid intimal medial thickness ( 0.0043, 0.2229) respectively. An inverse correlation was found between creatinine clearance and highly sensitive C-reactive protein ( 0.0174). Absolute flow mediated dilatation in brachial artery decreases with increasing Framingham risk score points and decreasing creatinine clearance ( 0.0044, 0.0269) respectively.

CONCLUSION

There is correlation between chronic kidney disease and impaired vascular function, subclinical atherosclerosis, and heightened inflammatory response. Chronic kidney disease patients are at increased risk of cardiovascular events with higher [10-]year cardiovascular risk.

摘要

背景

慢性肾脏病已成为一个公共卫生问题,增加了医疗负担。我们的目的是检测慢性肾脏病患者心血管风险、内皮功能障碍、炎症与肾功能之间的关系,并检测影响肾功能下降的非传统因素。

方法

一项横断面研究,纳入30例3 - 5期慢性肾脏病的男性和女性患者。计算肌酐清除率和弗雷明汉风险评分。测量颈动脉内膜中层厚度以及肱动脉的绝对血流介导的扩张。检测高敏C反应蛋白、甲状旁腺激素、肾功能指标和血脂谱。

结果

随着肌酐清除率降低,弗雷明汉风险评分和颈动脉内膜中层厚度分别显著增加(分别为0.0025,0.0285)。高敏C反应蛋白与弗雷明汉风险评分之间存在显著相关性,但与颈动脉内膜中层厚度无关(分别为0.0043,0.2229)。肌酐清除率与高敏C反应蛋白呈负相关(0.0174)。肱动脉的绝对血流介导的扩张随着弗雷明汉风险评分增加和肌酐清除率降低而降低(分别为0.0044,0.0269)。

结论

慢性肾脏病与血管功能受损、亚临床动脉粥样硬化和炎症反应增强之间存在相关性。慢性肾脏病患者发生心血管事件的风险增加,10年心血管风险更高。

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本文引用的文献

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Assessment of flow-mediated dilation in humans: a methodological and physiological guideline.人体血流介导扩张评估:方法学和生理学指南。
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