Rao Siyi, Zhang Jing, Lin Jiaqun, Wan Jianxin, Chen Yi
Department of Nephrology, Blood Purification Research Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China.
Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China.
J Clin Med. 2022 Dec 12;11(24):7373. doi: 10.3390/jcm11247373.
Introduction: With the invention and improvement of the carbon monoxide (CO) breath test, the role of shortened red blood cell life span (RBCLS) in renal anemia, an independent risk factor for cardiovascular events in patients with chronic kidney disease (CKD), is gradually attracting attention. Considering that heart failure is the leading cause of morbidity and mortality in patients with CKD, this study investigated the correlation between the RBCLS and the cardiac structure and function in non-dialysis patients with CKD stages 3−5, aiming to provide new ideas to improve the long-term prognosis of CKD patients. Methods: One hundred thirty-three non-dialysis patients with CKD stages 3−5 were tested for RBCLS. We compared the serological data, cardiac ultrasound results, and follow-up prognosis of patients with different RBCLS. Results: As the RBCLS shortened, the patients’ blood pressure, BNP, and CRP gradually increased, most significantly in patients with an RBCLS < 50 d. Patients with an RBCLS < 50 d had substantially lower hemoglobin (Hb), hematocrit, and albumin levels than those with an RBCLS ≥ 50 d. The cardiac ultrasound results show that patients with an RBCLS < 50 d had significantly larger atrial diameters than those with an RBCLS ≥ 50 d and were associated with more severe diastolic dysfunction. Patients with an RBCLS < 50 d had a 3.06 times greater risk of combined heart failure at baseline than those with an RBCLS ≥ 70 d and a higher risk of heart failure at follow-up. CKD stage 5 patients with an RBCLS < 50 d were more likely to develop heart failure and require renal replacement therapy earlier than patients with an RBCLS ≥ 50 d. Conclusions: In non-dialysis patients with CKD stages 3−5, there is a correlation between the red blood cell life span and cardiac structure and function. The RBCLS may also impact the renal prognosis of CKD patients.
随着一氧化碳（CO）呼气试验的发明与改进，红细胞寿命缩短（RBCLS）在肾性贫血中的作用逐渐受到关注，肾性贫血是慢性肾脏病（CKD）患者心血管事件的独立危险因素。鉴于心力衰竭是CKD患者发病和死亡的主要原因，本研究调查了3-5期非透析CKD患者的RBCLS与心脏结构和功能之间的相关性，旨在为改善CKD患者的长期预后提供新思路。方法：对133例3-5期非透析CKD患者进行RBCLS检测。我们比较了不同RBCLS患者的血清学数据、心脏超声结果和随访预后。结果：随着RBCLS缩短，患者的血压、脑钠肽（BNP）和C反应蛋白（CRP）逐渐升高，在RBCLS<50天的患者中最为显著。RBCLS<50天的患者血红蛋白（Hb）、血细胞比容和白蛋白水平显著低于RBCLS≥50天的患者。心脏超声结果显示，RBCLS<50天的患者心房直径显著大于RBCLS≥50天的患者，且与更严重的舒张功能障碍相关。RBCLS<50天的患者在基线时合并心力衰竭的风险是RBCLS≥70天患者的3.06倍，随访时发生心力衰竭的风险更高。RBCLS<50天的5期CKD患者比RBCLS≥50天的患者更易发生心力衰竭，且更早需要肾脏替代治疗。结论：在3-5期非透析CKD患者中，红细胞寿命与心脏结构和功能之间存在相关性。RBCLS也可能影响CKD患者的肾脏预后。
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