血压变异性与慢性肾脏病进展：系统评价和荟萃分析。
Blood Pressure Variability and the Progression of Chronic Kidney Disease: a Systematic Review and Meta-Analysis.
机构信息
Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China.
West China School of Medicine, Sichuan University, Chengdu, 610041, China.
出版信息
J Gen Intern Med. 2023 Apr;38(5):1272-1281. doi: 10.1007/s11606-022-08001-6. Epub 2023 Jan 17.
Abstract
BACKGROUND
Blood pressure variability (BPV) is a risk factor for poor prognosis including cardiovascular events, chronic kidney disease, and mortality, independent of elevated BP.
METHODS
We searched PubMed/Medline, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to November 23, 2022. Cohort studies reporting the association between BPV and chronic kidney disease (CKD) progression were selected. Hazard ratios were pooled using a random-effects model. Meta-regression, subgroup analyses, and sensitivity analyses were conducted.
RESULTS
A total of 23 studies were included in this systematic review and meta-analysis. Increased BPV was associated with progression of CKD (HR: 1.21, 95% CI: 1.09-1.33) and incidence of ESRD (HR: 1.08, 95% CI: 1.08-1.30). Among the different BPV metrics, high variation independent of mean (VIM), coefficient of variation (CV), standard deviation (SD), and average real variability (ARV) were indicated as predictors of CKD progression.
DISCUSSION
Increased BPV was associated with CKD progression.
摘要
背景
血压变异性（BPV）是包括心血管事件、慢性肾脏病和死亡率等不良预后的危险因素，独立于血压升高。
方法
我们从建库到 2022 年 11 月 23 日在 PubMed/Medline、EMBASE 和 Cochrane 对照试验中心注册库（CENTRAL）中进行了检索。选择了报告 BPV 与慢性肾脏病（CKD）进展之间关联的队列研究。使用随机效应模型汇总了风险比。进行了荟萃回归分析、亚组分析和敏感性分析。
结果
这项系统评价和荟萃分析共纳入了 23 项研究。BPV 增加与 CKD 进展（HR：1.21，95%CI：1.09-1.33）和 ESRD 发生率（HR：1.08，95%CI：1.08-1.30）相关。在不同的 BPV 指标中，独立于均值的高变异（VIM）、变异系数（CV）、标准差（SD）和平均真实变异（ARV）被认为是 CKD 进展的预测指标。
讨论
BPV 增加与 CKD 进展相关。
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