Ouyang Jun, Chen Kequan, Wang Hui, Huang Jiangnan
Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
School of Pharmacy, Guangxi Medical University, Nanning, China.
Medicine (Baltimore). 2024 Dec 27;103(52):e41007. doi: 10.1097/MD.0000000000041007.
This study aims to explore predictors of high-grade atherosclerotic renal artery stenosis (ARAS) in patients with chronic kidney disease (CKD). This was a retrospective study, and univariate analysis such as independent-sample t test or nonparametric test where appropriate was used to explore variables with significant difference between patients with high-grade ARAS and patients with low-grade ARAS. Then, multivariate logistic regression and receiver operating characteristic curve (ROC) analysis were performed for further research. In univariate analysis, we found that there was a significant difference in smoking history, estimated glomerular filtration rate (eGFR), cystatin C, fasting blood glucose and lymphocyte-to-monocyte ratio (LMR) between the 2 groups. Multivariate logistic regression analysis showed that eGFR (OR = 0.979, 95% CI: 0.962-0.996, P = .017), cystatin C (OR = 2.123, 95% CI: 1.118-4.030, P = .021) and LMR (OR = 0.639, 95% CI: 0.421-0.969, P = .035) were still associated with high-grade ARAS in patients with CKD. ROC analysis showed that eGFR (AUC: 0.681; sensitivity: 64.1%, specificity: 65.1%), cystatin C (AUC: 0.658; sensitivity: 74.6%, specificity: 53.85%) and LMR (AUC: 0.650; sensitivity: 66.70%, specificity: 62.00%). In patients with CKD, eGFR, and cystatin C and LMR were predictive parameters of high-grade ARAS, and among them, eGFR and LMR held the greatest predictive value for high-grade ARAS in patients with CKD.
本研究旨在探讨慢性肾脏病(CKD)患者中高级别动脉粥样硬化性肾动脉狭窄(ARAS)的预测因素。这是一项回顾性研究,采用独立样本t检验或适当的非参数检验等单因素分析来探讨高级别ARAS患者和低级别ARAS患者之间存在显著差异的变量。然后,进行多因素逻辑回归和受试者工作特征曲线(ROC)分析以作进一步研究。在单因素分析中,我们发现两组患者在吸烟史、估计肾小球滤过率(eGFR)、胱抑素C、空腹血糖和淋巴细胞与单核细胞比值(LMR)方面存在显著差异。多因素逻辑回归分析显示,eGFR(OR = 0.979,95%CI:0.962 - 0.996,P = 0.017)、胱抑素C(OR = 2.123,95%CI:1.118 - 4.030,P = 0.021)和LMR(OR = 0.639,95%CI:0.421 - 0.969,P = 0.035)仍与CKD患者的高级别ARAS相关。ROC分析显示,eGFR(AUC:0.681;敏感度:64.1%,特异度:65.1%)、胱抑素C(AUC:0.658;敏感度:74.6%,特异度:53.85%)和LMR(AUC:0.650;敏感度:66.70%,特异度:62.00%)。在CKD患者中,eGFR、胱抑素C和LMR是高级别ARAS的预测参数,其中,eGFR和LMR对CKD患者的高级别ARAS具有最大预测价值。