Nawano Takaaki, Ichikawa Kazunobu, Konta Tsuneo, Masakane Ikuto, Watanabe Masafumi
Department of Cardiology, Pulmonology, and Nephrology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
Department of Public Health and Hygiene, Yamagata University Graduate School of Medical Science, Yamagata, Japan.
Clin Exp Nephrol. 2025 Mar;29(3):342-349. doi: 10.1007/s10157-024-02579-3. Epub 2024 Oct 31.
Cardiovascular disease (CVD) is the leading cause of mortality in patients undergoing maintenance hemodialysis (HD), with various reported risk factors. Recovery time (RT) is a valuable indicator of post-dialysis fatigue. However, the association between RT and the onset of CVD remains unexplored. As such, this study aimed to determine the effect of RT on the onset of CVD.
Data from 620 patients undergoing maintenance HD at Yabuki Hospital and 3 related facilities (Yamagata Prefecture, Japan) as of December 31, 2020, were retrospectively analyzed. Patients were asked to respond to the question "How long does it take you to recover from a dialysis session?"; the response was defined as RT. The analysis was performed by categorizing patients into 2 groups according to RT: short RT (< 2 h); and long RT (≥ 2 h). The primary outcome was major adverse cardiovascular events (MACE). Secondary outcomes included all-cause death and hospitalization.
During the 24-month follow-up, 70 (11.3%) patients developed MACE. The long RT group exhibited a higher incidence of MACE; multivariate analysis revealed that age and long RT were associated with the onset of MACE. All-cause death was observed in 45 (7.3%) patients, with no significant difference between the 2 groups. Hospitalization occurred in 252 (40.6%) patients and was more frequent in the long RT group. Multivariate analysis revealed that age, sex, duration of HD, intact parathyroid hormone level, and long RT were associated with hospitalization.
Long RT was an independent risk factor for the onset of CVD.
心血管疾病（CVD）是维持性血液透析（HD）患者的主要死亡原因，有多种已报道的风险因素。恢复时间（RT）是透析后疲劳的一个重要指标。然而，RT与CVD发病之间的关联尚未得到探索。因此，本研究旨在确定RT对CVD发病的影响。
回顾性分析了截至2020年12月31日在日本山形县八木医院及3个相关机构接受维持性HD的620例患者的数据。患者被问及“你从一次透析治疗中恢复需要多长时间？”；该回答被定义为RT。根据RT将患者分为两组进行分析：短恢复时间组（<2小时）；长恢复时间组（≥2小时）。主要结局是主要不良心血管事件（MACE）。次要结局包括全因死亡和住院。
在24个月的随访期间，70例（11.3%）患者发生了MACE。长恢复时间组的MACE发生率更高；多因素分析显示年龄和长恢复时间与MACE的发病相关。45例（7.3%）患者发生了全因死亡，两组之间无显著差异。252例（40.6%）患者发生了住院，长恢复时间组更为频繁。多因素分析显示年龄、性别、HD持续时间、完整甲状旁腺激素水平和长恢复时间与住院相关。
长恢复时间是CVD发病的独立危险因素。
