Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.
Department of Nutrition, Oslo New University College, Oslo, Norway.
BMC Nephrol. 2022 Apr 30;23(1):165. doi: 10.1186/s12882-022-02771-1.
A diagnosis of chronic kidney disease has been strongly associated with cardiovascular disease and mortality in a number of studies, but the association with specific causes of death has not been assessed in detail. We analysed the association between chronic kidney disease and all-cause mortality and 54 causes of death in the National Health Interview Survey, a prospective study of 210,748 US adults.
We used multivariable Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality associated with self-reported chronic kidney disease. Men and women aged 18-84 years were recruited between 1997 and 2004 and followed up for mortality through December 31, 2006.
During an average of 6 years follow-up, 9564 deaths occurred. A history of chronic kidney disease vs. no chronic kidney disease was associated with increased risk of all-cause mortality (HR = 2.69, 95% CI: 2.38-3.04), and mortality from septicemia (5.65, 2.84-11.25), viral hepatitis (10.67, 2.43-46.95), other infectious parasitic diseases (10.58, 3.59-31.21), total cancer (1.48, 1.05-2.09), lung cancer (1.94, 1.10-3.44), kidney cancer (4.74, 1.81-12.41), diabetes mellitus (8.57, 5.60-13.11), circulatory disease overall (3.36, 2.70-4.18) and 11 specific circulatory diseases with the strongest associations observed for primary hypertension/renal disease (13.60, 6.42-28.84), hypertensive heart/renal disease (10.72, 2.47-46.49), and other diseases of circulatory system (7.36, 3.22-16.81). Elevated risk was also observed for alcoholic liver disease (5.63, 1.90-16.66), other chronic liver disease (4.41, 1.74-11.17), kidney failure (13.07, 8.23-20.77), and five other causes of death.
A history of chronic kidney disease was associated with increased risk of all-cause mortality and 27 out of 54 causes of death. Further studies are needed to clarify associations with less common causes of death.
多项研究表明，慢性肾病与心血管疾病和死亡率密切相关，但尚未详细评估其与特定死因的关系。我们分析了慢性肾病与全美健康访谈调查中 210748 名美国成年人的全因死亡率和 54 种死因之间的关系，该调查是一项前瞻性研究。
我们使用多变量 Cox 回归模型来估计与自我报告的慢性肾病相关的全因和特定死因死亡率的风险比 (HR) 和 95%置信区间 (CI)。18-84 岁的男性和女性于 1997 年至 2004 年期间招募，并通过 2006 年 12 月 31 日的死亡率进行随访。
在平均 6 年的随访期间，发生了 9564 例死亡。与无慢性肾病相比，有慢性肾病病史与全因死亡率增加相关 (HR=2.69，95%CI：2.38-3.04)，败血症 (5.65，2.84-11.25)、病毒性肝炎 (10.67，2.43-46.95)、其他传染性寄生虫病 (10.58，3.59-31.21)、总癌症 (1.48，1.05-2.09)、肺癌 (1.94，1.10-3.44)、肾癌 (4.74，1.81-12.41)、糖尿病 (8.57，5.60-13.11)、循环系统疾病总体 (3.36，2.70-4.18)，以及 11 种特定的循环系统疾病，其中原发性高血压/肾病 (13.60，6.42-28.84)、高血压性心脏病/肾病 (10.72，2.47-46.49)和其他循环系统疾病 (7.36，3.22-16.81)的相关性最强。酒精性肝病 (5.63，1.90-16.66)、其他慢性肝病 (4.41，1.74-11.17)、肾衰竭 (13.07，8.23-20.77)和其他 5 种死因也存在较高的风险。
慢性肾病病史与全因死亡率和 54 种死因中的 27 种死因风险增加相关。需要进一步的研究来阐明与不太常见的死因的关系。
