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外周血嗜酸性粒细胞计数与慢性肾脏病进展风险的关联:中国人群的回顾性队列研究。

Association of peripheral eosinophil count with chronic kidney disease progression risk: a retrospective cohort study in Chinese population.

机构信息

Department of Nephrology, Urology & Nephrology Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.

出版信息

Ren Fail. 2024 Dec;46(2):2394164. doi: 10.1080/0886022X.2024.2394164. Epub 2024 Aug 30.

Abstract

BACKGROUND

The role of peripheral eosinophils in chronic kidney disease (CKD) requires further evaluation. We aimed to determine whether an eosinophil count increase is related to the occurrence of end-stage renal disease (ESRD).

METHODS

This single-center, observational, retrospective cohort study was conducted between January 2016 and December 2018 in Hangzhou, China, and included 3163 patients, categorized into four groups according to peripheral eosinophil count (PEC) quartile values. The main outcome was ESRD development during follow-up. We evaluated the relationship between the serum eosinophil count, demographic and clinical information, and ESRD incidence. Cox proportional hazards models and Kaplan-Meier survival curves were used.

RESULTS

A total of 3163 patients with CKD were included in this cohort, of whom 1254 (39.6%) were females. The median (interquartile range [IQR]) age was 75 [64, 85] years, and the median (IQR) estimated glomerular filtration rate was 55.16 [45.19, 61.19] mL/min/1.73 m. The median PEC was 0.1224 × 10/L (IQR, 0.0625-0.212). Among the 3163 patients with CKD, 273 (8.6%) developed ESRD during a median follow-up time of 443.8 [238.8, 764.9] days. Individuals in the highest PEC quartile had a 66.2% higher ESRD risk than those in the lowest quartile (hazard ratio, 1.662; 95% confidence interval, 1.165-2.372). The results from the Kaplan-Meier survival curves confirmed the conclusion.

CONCLUSIONS

Alongside traditional risk factors, patients with CKD and an elevated PEC are more likely to develop ESRD. Therefore, more attention should be paid to those patients with CKD who have a high PEC.

摘要

背景

外周血嗜酸性粒细胞在慢性肾脏病(CKD)中的作用仍需进一步评估。本研究旨在明确嗜酸性粒细胞计数升高是否与终末期肾病(ESRD)的发生有关。

方法

本单中心、观察性、回顾性队列研究于 2016 年 1 月至 2018 年 12 月在中国杭州进行,共纳入 3163 例患者,根据外周血嗜酸性粒细胞计数(PEC)四分位值分为 4 组。主要结局为随访期间 ESRD 的发生。评估血清嗜酸性粒细胞计数、人口统计学和临床信息与 ESRD 发生率之间的关系。采用 Cox 比例风险模型和 Kaplan-Meier 生存曲线进行分析。

结果

本队列共纳入 3163 例 CKD 患者,其中 1254 例(39.6%)为女性。患者年龄中位数(四分位距)为 75 [64, 85] 岁,估算肾小球滤过率中位数(四分位距)为 55.16 [45.19, 61.19] ml/min/1.73 m2。PEC 中位数为 0.1224 × 109/L(四分位距,0.0625-0.212)。在 3163 例 CKD 患者中,273 例(8.6%)在中位随访时间 443.8 [238.8, 764.9] 天内发生 ESRD。最高 PEC 四分位组患者发生 ESRD 的风险比最低四分位组高 66.2%(风险比,1.662;95%置信区间,1.165-2.372)。Kaplan-Meier 生存曲线的结果进一步证实了这一结论。

结论

除了传统的危险因素外,CKD 患者的 PEC 升高也与 ESRD 的发生相关。因此,应更加关注那些 PEC 较高的 CKD 患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32a9/11370690/bf076942fd75/IRNF_A_2394164_F0001_B.jpg

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