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慢性肾脏病各阶段对血脂异常、心血管疾病患病率及死亡率的影响。

The effects of chronic kidney disease stages on dyslipidemia, cardiovascular disease prevalence and mortality.

作者信息

Hoca Emre, Mermer Huseyin Bulent, Kula Atay Can, Ahbab Suleyman, Ataoglu Hayriye Esra

机构信息

Department of Internal Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye.

Department of Internal Medicine, Bodrum State Hospital, Mugla, Turkiye.

出版信息

North Clin Istanb. 2025 Jan 28;12(1):95-102. doi: 10.14744/nci.2024.81582. eCollection 2025.

Abstract

OBJECTIVE

Cardiovascular disease (CVD) is the most common cause of death in chronic kidney disease (CKD) patients. The prevalence of CVD is significantly increased in CKD patients, and the frequency of CVD increases as the CKD stage worsens. Although atherosclerosis is more common in CKD patients, the lipid profile may change as the CKD stage changes. Many mechanisms cause this. Also, mortality is more common in patients with advanced CKD. In this study, we aim to emphasize the incidence of cardiovascular diseases and dyslipidemia in patients with CKD at different stages and the effect of these variable conditions on patient mortality.

METHODS

Patients who applied to the internal medicine outpatient clinic and were diagnosed with chronic kidney disease were examined. Mortality and complications were followed up for one year. A total of 1323 patients with a diagnosis of CKD between stages 3a-5 were included in the study. The relationships between kidney functions and lipid profiles, biochemical values, and prognosis of the patients were evaluated.

RESULTS

Non-survivors had lower glomerular filtration rate (GFR) and higher C-reactive protein (CRP) levels. High-density lipoprotein (HDL), low-density lipoprotein (LDL), and albumin values decreased, and CRP increased as the disease stage progressed. More survivors had CKD and hyperlipidemia than non-survivors. It was observed that the stage remained the same in patients with hyperlipidemia at a higher rate. In contrast, the stage worsened or remained at stage 5 more in patients with cardiovascular disease or diabetes mellitus. Declining CKD stage and increasing CRP were influential risk factors that affect mortality.

CONCLUSION

It is essential to closely monitor the changes in laboratory parameters at baseline and follow-up in CKD patients to predict or prevent comorbidities, mortality, and deterioration in patients' renal functions.

摘要

目的

心血管疾病(CVD)是慢性肾脏病(CKD)患者最常见的死亡原因。CKD患者中CVD的患病率显著增加,且随着CKD分期的恶化,CVD的发生率也会增加。虽然动脉粥样硬化在CKD患者中更为常见,但脂质谱可能会随着CKD分期的变化而改变。造成这种情况的机制有很多。此外,晚期CKD患者的死亡率更高。在本研究中,我们旨在强调不同阶段CKD患者心血管疾病和血脂异常的发生率,以及这些可变因素对患者死亡率的影响。

方法

对申请到内科门诊就诊并被诊断为慢性肾脏病的患者进行检查。对死亡率和并发症进行了一年的随访。共有1323例3a - 5期CKD诊断患者纳入本研究。评估了患者肾功能与脂质谱、生化值及预后之间的关系。

结果

非存活者的肾小球滤过率(GFR)较低,C反应蛋白(CRP)水平较高。随着疾病阶段的进展,高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和白蛋白值下降,CRP升高。存活者中患有CKD和高脂血症的比例高于非存活者。观察到高脂血症患者病情维持在同一阶段的比例更高。相比之下,患有心血管疾病或糖尿病的患者病情恶化或维持在5期的比例更高。CKD分期下降和CRP升高是影响死亡率的重要危险因素。

结论

密切监测CKD患者基线和随访时实验室参数的变化对于预测或预防患者的合并症、死亡率及肾功能恶化至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a399/12364478/ece50a24edee/NCI-12-095-g001.jpg

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