慢性肾脏病中与动脉僵硬度相关的临床因素

Clinical Factors Associated with Arterial Stiffness in Chronic Kidney Disease.

作者信息

Yao Jin, Dong Zheyi, Wang Qian, Li Zhe, Zhang Weiguang, Lin Wenwen, Luo Yayong, Li Hangtian, Guo Xinru, Zhang Li, Cai Guangyan, Shen Wanjun, Duan Shuwei, Chen Xiangmei

机构信息

School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China.

Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China.

出版信息

J Clin Med. 2023 Jan 30;12(3):1077. doi: 10.3390/jcm12031077.

DOI:10.3390/jcm12031077

PMID:36769724

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9917394/

Abstract

BACKGROUND

Arterial stiffness influences the prognosis of patients with end-stage kidney disease; however, the factors that promote arterial stiffness in chronic kidney disease (CKD) patients remain unknown. We aimed to explore the clinical factors associated with arterial stiffness in CKD.

METHODS

Between September 2017 and September 2022, all CKD patients treated at the Department of Nephrology, General Hospital of the Chinese People's Liberation Army, excluding dialysis patients, were screened and their medical records within the last month were collected. Arterial stiffness was measured by the augmentation index (AIx). The correlative clinical factors with arterial stiffness were explored in different linear regression models.

RESULTS

559 patients were included in the study. AIx@75 increased as the deterioration of CKDG1-CKDG5, with values of 1 (-9, 11), 5.5 (-4, 13.25), 9 (0, 16), 12 (1.5, 23.5), and 22 (13, 28), respectively (Z = 63.03, < 0.001). Multivariate linear regression analysis showed that AIx@75 was positively associated with female sex (β = 8.926, 95% confidence interval (CI) 6.291, 11.562, < 0.001), age (β = 0. 485, 95% CI 0.39, 0.58, < 0.001), mean arterial pressure (MAP) (β = 0.255, 95% CI 0.159, 0.35, < 0.001), and was negatively associated with ACEI/ARB (β = -4.466, 95% CI -6.963, -1.969, < 0.001) and glucocorticoid (β = -3.163, 95% CI -6.143, -0.183, = 0.038). Smoking, eGFR, hemoglobin, and cause of disease were associated with AIx@75 in multivariate linear regression models when considering factors partly.

CONCLUSIONS

Female, age, smoking, MAP, eGFR, cause of disease, ACEI/ARB, and glucocorticoid were found to be associated with atherosclerosis in CKD patients.

摘要

背景

动脉僵硬度影响终末期肾病患者的预后；然而，慢性肾脏病（CKD）患者中促进动脉僵硬度增加的因素仍不清楚。我们旨在探讨与CKD患者动脉僵硬度相关的临床因素。

方法

2017年9月至2022年9月期间，对中国人民解放军总医院肾病科治疗的所有CKD患者（不包括透析患者）进行筛查，并收集他们近1个月内的病历。采用增强指数（AIx）测量动脉僵硬度。在不同的线性回归模型中探讨与动脉僵硬度相关的临床因素。

结果

本研究共纳入559例患者。随着CKD从G1期进展至G5期，AIx@75升高，其值分别为1（-9，11）、5.5（-4，13.25）、9（0，16）、12（1.5，23.5）和22（13，28）（Z = 63.03，P < 0.001）。多因素线性回归分析显示，AIx@75与女性（β = 8.926，95%置信区间（CI）6.291，11.562，P < 0.001）、年龄（β = 0.485，95%CI 0.39，0.58，P < 0.001）、平均动脉压（MAP）（β = 0.255，95%CI 0.159，0.35，P < 0.001）呈正相关，与ACEI/ARB（β = -4.466，95%CI -6.963，-1.969，P < 0.001）和糖皮质激素（β = -3.163，95%CI -6.143，-0.183，P = 0.038）呈负相关。部分考虑因素时，吸烟、估算肾小球滤过率（eGFR）、血红蛋白及病因在多因素线性回归模型中与AIx@75相关。