Dong Hui, Zhou Lang, Yang Luyu, Lu Huizhi, Cao Song, Song Huimin, Fu Shouzhi
Department of Intensive Care Unit, Wuhan Third Hospital, Wuhan, 430000, Hubei, People's Republic of China.
Department of Interventional Medicine, Wuhan Third Hospital, Wuhan, 430000, Hubei, People's Republic of China.
Int Urol Nephrol. 2023 Jun;55(6):1597-1607. doi: 10.1007/s11255-023-03466-8. Epub 2023 Jan 31.
Dialysis or non-dialysis end-stage renal disease (ESRD) patients are accompanied by cardiovascular disease (CVD) or hypertension. We aimed to study the effect of a common treatment for CVD, β-blockers, on the survival of ESRD patients, improving their prognosis from the perspective of drug therapy.
It was a retrospective cohort study using the Medical Information Mart for Intensive Care dataset. ESRD patients in the intensive care unit from June 2001 to October 2012 were included. We examined the effect of using versus not using β-blockers in the overall population and subgroups with the risk of 28-day and 3-year mortality through Cox proportional hazards models and Kaplan-Meier curves.
A total of 1639 participants were included with 371 (22.64%) β-blockers users. There were 315 (19.22%) 28-day and 970 (59.18%) 3-year mortality events during follow-up. Using β-blockers in overall ESRD patients could reduce all-cause 28-day mortality [adjusted hazard ratio (HR) 0.450, 95% confidence interval (CI) 0.325-0.624] and 3-year mortality (adjusted HR 0.695, 95% CI 0.589-0.821). This result was consistent among subgroups (ESRD without hypertension: adjusted HR 0.412, 95% CI 0.289-0.588; with CVD: adjusted HR 0.478, 95% CI 0.321-0.711; without CVD: adjusted HR 0.448, 95% CI 0.248-0.810; with dialysis: adjusted HR 0.471, 95% CI 0.320-0.694) in 28-day mortality, and the 3-year mortality was consistent. In ESRD patients with hypertension and without dialysis subgroups, β-blockers had no effect on survival.
Using β-blockers could reduce the risk of 28-day and 3-year mortality in ESRD patients, including those with CVD. This study provided a reference for the treatment of β-blockers in patients with ESRD.
透析或非透析终末期肾病（ESRD）患者常伴有心血管疾病（CVD）或高血压。我们旨在研究心血管疾病的一种常用治疗方法β受体阻滞剂对ESRD患者生存的影响，从药物治疗角度改善其预后。
这是一项使用重症监护医学信息集市数据集的回顾性队列研究。纳入2001年6月至2012年10月期间入住重症监护病房的ESRD患者。我们通过Cox比例风险模型和Kaplan-Meier曲线研究了在总体人群以及有28天和3年死亡风险的亚组中使用与不使用β受体阻滞剂的效果。
共纳入1639名参与者，其中371名（22.64%）使用β受体阻滞剂。随访期间有315例（19.22%）28天死亡事件和970例（59.18%）3年死亡事件。在总体ESRD患者中使用β受体阻滞剂可降低全因28天死亡率[调整后风险比（HR）0.450，95%置信区间（CI）0.325 - 0.624]和3年死亡率（调整后HR 0.695，95% CI 0.589 - 0.821）。该结果在亚组中一致（无高血压的ESRD：调整后HR 0.412，95% CI 0.289 - 0.588；伴有CVD：调整后HR 0.478，95% CI 0.321 - 0.711；无CVD：调整后HR 0.448，95% CI 0.248 - 0.810；接受透析：调整后HR 0.471，95% CI 0.320 - 0.694）在28天死亡率方面，3年死亡率情况也一致。在有高血压且未接受透析的ESRD患者亚组中，β受体阻滞剂对生存无影响。
使用β受体阻滞剂可降低ESRD患者28天和3年死亡风险，包括伴有CVD的患者。本研究为ESRD患者β受体阻滞剂的治疗提供了参考。
