接受维持性血液透析患者死亡前的踝臂指数轨迹
Ankle-brachial index trajectory before death in patients receiving maintenance hemodialysis.
作者信息
Yamabe Sachi, Harada Manae, Suzuki Yuta, Aoyama Naoyoshi, Watanabe Takaaki, Fukuzaki Narumi, Shoji Tetsuo, Matsunaga Atsuhiko
机构信息
Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan.
Department of Rehabilitation, Faculty of Health Sciences, Japan Healthcare University, Sapporo, Hokkaido, Japan.
出版信息
Clin Exp Nephrol. 2025 Aug 17. doi: 10.1007/s10157-025-02747-z.
BACKGROUND
The trajectory of the ankle-brachial index (ABI) over time in relation to death has not been fully described in patients undergoing hemodialysis. We modeled ABI trajectory pattern before death in patients undergoing maintenance hemodialysis.
METHODS
Patients undergoing hemodialysis in a dialysis facility were retrospectively enrolled and categorized into two groups, deceased and surviving groups, based on their status at the end of the observation period. Linear mixed-effect model and a backward timescale from the year of death or study end date were used to compare ABI trajectory between the deceased and surviving groups during the observation period.
RESULTS
A total of 442 patients (median age, 65 years; 60.2%, men) were included. During the observation period (median, 5.3 years; maximum, 8.5 years), 130 deaths were observed. Differences in ABI between the deceased and survivors were detected in the early stages (difference at 7 years before death, 0.08; p = 0.01), with the differences between these groups becoming more pronounced at 1 year before death (difference at 1 year before death, 0.11; p < 0.001).
CONCLUSIONS
Differences in ABI trajectory between the deceased and survivors were detected from the early stages to just before death.
背景
在接受血液透析的患者中，踝臂指数（ABI）随时间变化与死亡相关的轨迹尚未得到充分描述。我们对接受维持性血液透析的患者死亡前的ABI轨迹模式进行了建模。
方法
对一家透析机构中接受血液透析的患者进行回顾性纳入，并根据观察期结束时的状态将其分为两组，即死亡组和存活组。使用线性混合效应模型和从死亡年份或研究结束日期开始的反向时间尺度，比较观察期内死亡组和存活组之间的ABI轨迹。
结果
共纳入442例患者（中位年龄65岁；男性占60.2%）。在观察期（中位时间5.3年；最长8.5年）内，观察到130例死亡。在早期阶段检测到死亡组和存活组之间的ABI存在差异（死亡前7年的差异为0.08；p = 0.01），这些组之间的差异在死亡前1年变得更加明显（死亡前1年的差异为0.11；p < 0.001）。
结论
从早期到死亡前，检测到死亡组和存活组之间的ABI轨迹存在差异。
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