Anemia as a risk factor for all-cause mortality: obscure synergic effect of chronic kidney disease
Anemia as a risk factor for all-cause mortality: obscure synergic effect of chronic kidney disease
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DOI：
10.1007/s10157-017-1468-8
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发表时间：
2018-04-01
影响因子：
2.3
通讯作者：
Watanabe, Tsuyoshi
中科院分区：
文献类型：
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作者：
Sato, Yuji;Fujimoto, Shouichi;Watanabe, Tsuyoshi
贫血在慢性肾病（CKD）中很常见，可能与CKD患者的死亡率相关。然而，很少有研究在亚洲人群中研究这种关系。2008年至2012年，共有62，931名日本人（年龄64.0 ± 8.0岁;男性38.5%）接受了随访。根据肾小球滤过率（eGFR）（< 45，45-59，ae 60 mL/min/1.73 m2）和血红蛋白水平（男性13.0 g/dL;女性12.0 g/dL）将参与者分为6组。计算eGFR和贫血联合使用时死亡率的风险比和置信区间（CI）。在使用贫血倾向评分（PS）进行匹配后，对贫血和非贫血人群进行生存分析，独立于一些变量，包括eGFR，共828例（1.3%）参与者死亡（非贫血vs.贫血，1.2 vs. 2.3%，p < 0.01）。多变量考克斯分析表明，独立于eGFR水平，贫血的人有显着较高的死亡率。根据PS匹配队列的对数秩检验（p < 0.01），发现贫血患者的生存率显著低于非贫血患者。进一步分层Logistic回归分析显示，贫血是全因死亡的独立危险因素，其OR（95% CI）为2.25（1.89-2.67），P <0.01。
Anemia is common in chronic kidney disease (CKD) and may be associated with mortality in CKD patients. However, few studies have examined this relationship in Asian populations.A total of 62,931 Japanese people (age 64.0 +/- 8.0 years; men 38.5%) were followed up from 2008 to 2012. Participants were divided into six groups in accordance with their estimated glomerular filtration rate (eGFR) (< 45, 45-59, ae60 mL/min/1.73 m(2)) and by hemoglobin levels (13.0 g/dL for men; 12.0 g/dL for women). Hazard ratio and confidence interval (CI) for mortality with a combination of eGFR and anemia were calculated. After matching using propensity score (PS) for anemia, survival analysis between anemic and non-anemic people, independent from some variables, including eGFR, was performed.A total of 828 (1.3%) participants died (non-anemic vs. anemic, 1.2 vs. 2.3%, p < 0.01). Multivariable Cox analysis showed that, independent of eGFR levels, anemic people had significantly higher mortality. Anemic people were found to have significantly poorer survival than non-anemic people as per a log-rank test (p < 0.01) for the PS-matching cohort. Further stratified logistic analysis using PS in the overall cohort odds ratio (95% CI) showed 2.25 (1.89-2.67) with p < 0.01.The results of the present study showed that anemia was an independent risk factor of all-cause mortality.