Feng Xiao-Hua, Chen Yi, Chen Xue-Qi, Zhao Wei-Hong
Division of Nephrology, Department of Geriatrics, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, P. R. China.
J Clin Hypertens (Greenwich). 2025 Jan;27(1):e14971. doi: 10.1111/jch.14971.
This study aimed to assess the correlation between estimated pulse wave velocity (ePWV) and mortality rates related to all-cause and cardiovascular disease (CVD) among individuals diagnosed with chronic kidney disease (CKD) in the United States. A total of 4669 participants with CKD were identified from the National Health and Nutrition Examination Survey conducted between 1999 and 2018. We calculated the incidence of CKD using an estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73 m. Our study examined the association between ePWV and mortality risk based on weighted Kaplan-Meier plots and multivariate Cox regression. Linear testing between ePWV and mortality from all causes and CVD was performed using restricted cubic splines and Cox regression. This study included 4669 patients with CKD from the NHANES, representing 37 million Americans with CKD. There was a mean age of 71.9 years, and 48.1% of participants were male. With every increase of 1 m/s in ePWV measurement, there is a corresponding 31% (hazard ratio [HR]: 1.31, 95% confidence interval [CI]: 1.28-1.34) increase in the rate of mortality from all causes and a 32% (HR: 1.32, 95% CI: 1.27-1.37) increase in the rate of mortality from CVD. A significantly higher rate of cardiovascular and all-cause mortality was observed in patients with CKD with elevated ePWV than in those with lower ePWV, as shown in the weighted Kaplan-Meier plots. Patients with CKD have a significant relationship between ePWV and all-cause and cardiovascular mortality.
本研究旨在评估美国慢性肾脏病（CKD）患者中估计脉搏波速度（ePWV）与全因死亡率及心血管疾病（CVD）死亡率之间的相关性。从1999年至2018年进行的美国国家健康与营养检查调查中，共识别出4669名CKD参与者。我们使用估算肾小球滤过率（eGFR）<60 mL/min/1.73 m²来计算CKD的发病率。我们的研究基于加权Kaplan-Meier曲线和多变量Cox回归，检验了ePWV与死亡风险之间的关联。使用受限立方样条和Cox回归对ePWV与全因死亡率和CVD死亡率之间进行线性检验。本研究纳入了来自美国国家健康与营养检查调查（NHANES）的4669例CKD患者，代表了3700万患有CKD的美国人。平均年龄为71.9岁，48.1%的参与者为男性。ePWV测量值每增加1 m/s，全因死亡率相应增加31%（风险比[HR]：1.31，95%置信区间[CI]：1.28 - 1.34），CVD死亡率增加32%（HR：1.32，95% CI：1.27 - 1.37）。如加权Kaplan-Meier曲线所示，ePWV升高的CKD患者的心血管和全因死亡率显著高于ePWV较低的患者。CKD患者的ePWV与全因死亡率和心血管死亡率之间存在显著关系。
