Martínez-Quintana Efrén, Rodríguez-González Fayna
Cardiology Service, Complejo Hospitalario Universitario Insular-Materno Infantil, Avd. Marítima del Sur s/n, 35016 Las Palmas de Gran Canaria, Spain.
Department of Medical and Surgical Sciences, Faculty of Health Sciences, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.
J Clin Med. 2024 Nov 19;13(22):6963. doi: 10.3390/jcm13226963.
: Patients with congenital heart disease (CHD) show risk factors for chronic kidney disease (CKD) and it is well known that CKD has a large negative impact on survival. : Observational and prospective cohort study. Adult CHD patients and controls were matched for age and sex. : A total of 657 CHD adult patients (cases) and 1954 controls were studied. Median age in CHD patients was 30 (17-62) years and 373 (57%) were male. The prevalence of CKD (Glomerular filtration rate (GFR) < 60 mL/min/1.73 m) was 0.2% and 4.5% in the control and CHD groups, respectively. Binary logistic regression analysis determined as risk factors for CKD in CHD patients: age [1.54 (1.04-1.28), = 0.009], dyslipidemia [19.8 (1.35-301.1), = 0.031], low iron concentration [0.96 (0.96-0.93), = 0.048], cyanosis [25.7 (1.60-411.8), = 0.022], and Down syndrome [46.8 (8.09-2710), = 0.003]. During a follow-up time of 6.8 (1.2-10.5) years, cardiovascular mortality occurred in 31 patients with CHD showing, through the Kaplan-Meier test, a worse outcome among patients with CKD ( < 0.05) as was also seen in the univariate Cox regression survival analysis. However, after adjusting for other variables, this significance was lost, with age remaining as the unique independent prognostic factor. : The prevalence of CKD was much higher in patients with CHD than in the control group; age, cyanosis, and Down syndrome were the predictors of a higher risk of CKD among CHD patients. Although CKD was associated with worse survival in CHD patients, only age was identified as an independent prognostic factor for cardiovascular mortality.
先天性心脏病（CHD）患者表现出慢性肾脏病（CKD）的危险因素，并且众所周知，CKD对生存率有很大的负面影响。：观察性和前瞻性队列研究。成年CHD患者和对照组按年龄和性别匹配。：共研究了657例成年CHD患者（病例）和1954例对照。CHD患者的中位年龄为30（17 - 62）岁，373例（57%）为男性。CKD（肾小球滤过率（GFR）<60 mL/min/1.73 m²）在对照组和CHD组中的患病率分别为0.2%和4.5%。二元逻辑回归分析确定CHD患者中CKD的危险因素为：年龄[1.54（1.04 - 1.28），P = 0.009]、血脂异常[19.8（1.35 - 301.1），P = 0.031]、低铁浓度[0.96（0.96 - 0.93），P = 0.048]、发绀[25.7（1.60 - 411.8），P = 0.022]和唐氏综合征[46.8（8.09 - 271.0），P = 0.003]。在6.8（1.2 - 10.5）年的随访期内，31例CHD患者发生心血管死亡，通过Kaplan - Meier检验显示，CKD患者的预后较差（P < 0.05），单因素Cox回归生存分析中也可见此情况。然而，在对其他变量进行校正后，这种显著性消失，年龄仍然是唯一的独立预后因素。：CHD患者中CKD的患病率远高于对照组；年龄、发绀和唐氏综合征是CHD患者中CKD风险较高的预测因素。虽然CKD与CHD患者较差的生存率相关，但只有年龄被确定为心血管死亡的独立预后因素。
