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支气管扩张症及其严重程度对长期肾脏结局的影响。

The impact of bronchiectasis and its severity on long-term renal outcomes.

机构信息

Division of Respiratory Medicine and Critical Care Medicine, and.

Division of Nephrology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong.

出版信息

Int J Tuberc Lung Dis. 2024 Sep 1;28(9):427-432. doi: 10.5588/ijtld.24.0090.

Abstract

INTRODUCTIONWhile bronchiectasis is associated with adverse cardiovascular outcomes, data regarding its impact on long-term renal outcomes is lacking.METHODSWe reviewed bronchiectasis patients followed up at Queen Mary Hospital in 2017 and examined their clinical/renal outcomes in the subsequent five years. The relationships between the severity of bronchiectasis as defined by FACED (FEV, Age, Chronic colonisation, Extension, Dyspnoea) scores and adverse renal outcomes were evaluated.RESULTSA total of 315 bronchiectasis patients were included. Seventy-five patients (23.8%) showed renal progression. Baseline FACED score showed a positive correlation with renal progression over 5 years of follow-up (adjusted odds ratio [aOR] 1.30 (95% CI 1.083-1.559, = 0.005). Patients with moderate-to-severe bronchiectasis (FACED score ≥3) showed an increased risk of renal progression (aOR 1.833, 95% CI 1.082-3.106; = 0.024) and more rapid decline in estimated glomerular filtration rate than those with mild disease (-4.77 ± 4.19 mL/min/1.73 m²/year vs. -3.49 ± 3.94 mL/min/1.73 m²/year; = 0.006). Patients who developed renal progression had a higher risk of death (adjusted hazard ratio [aHR] 3.056, 95% CI 1.505-6.206; = 0.002) and subsequent rates of hospitalisation (1.56 ± 2.81 episodes/year vs. 0.60 ± 1.18 episodes/year; < 0.001) compared to those without renal progression.CONCLUSIONSProgressive renal function deterioration is prevalent among bronchiectasis patients, and the severity of bronchiectasis is a robust predictor of renal progression..

摘要

引言虽然支气管扩张与不良心血管结局相关,但关于其对长期肾脏结局影响的数据尚缺乏。方法我们回顾了 2017 年在玛丽皇后医院就诊的支气管扩张症患者,并在随后的五年内检查了他们的临床/肾脏结局。评估了 FACED(FEV、年龄、慢性定植、扩展、呼吸困难)评分定义的支气管扩张严重程度与不良肾脏结局之间的关系。结果共纳入 315 例支气管扩张症患者。75 例(23.8%)出现肾脏进展。基线 FACED 评分与 5 年随访期间的肾脏进展呈正相关(调整后优势比[aOR]1.30(95%可信区间 1.083-1.559, = 0.005)。中重度支气管扩张症(FACED 评分≥3)患者的肾脏进展风险增加(aOR 1.833,95%可信区间 1.082-3.106; = 0.024),肾小球滤过率下降速度快于轻度疾病患者(-4.77±4.19mL/min/1.73m²/年比-3.49±3.94mL/min/1.73m²/年; = 0.006)。发生肾脏进展的患者死亡风险更高(调整后的危险比[aHR]3.056,95%可信区间 1.505-6.206; = 0.002),随后的住院率(1.56±2.81 次/年比 0.60±1.18 次/年; < 0.001)也高于无肾脏进展的患者。结论支气管扩张症患者中肾功能进行性恶化较为常见,支气管扩张症的严重程度是肾脏进展的有力预测指标。.

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