Combination of low body mass index and serum albumin level is associated with chronic kidney disease progression: the chronic kidney disease-research of outcomes in treatment and epidemiology (CKD-ROUTE) study
Combination of low body mass index and serum albumin level is associated with chronic kidney disease progression: the chronic kidney disease-research of outcomes in treatment and epidemiology (CKD-ROUTE) study
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DOI：
10.1007/s10157-016-1251-2
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发表时间：
2017-02-01
影响因子：
2.3
通讯作者：
Uchida, Shinichi
中科院分区：
文献类型：
--
作者：
Kikuchi, Hiroaki;Kanda, Eiichiro;Uchida, Shinichi
蛋白质-能量消耗与慢性肾脏病（CKD）进展之间的关系尚不清楚。在目前的前瞻性队列研究中，我们评估的假设，低体重指数（BMI）和血清白蛋白水平的组合与快速CKD progress.Methods的研究队列包括728例透析前日本CKD患者（阶段2-5）从2010年至2011年入组。根据血清白蛋白水平和BMI将患者分为4组：第1组，低血清白蛋白水平（= 23.5 kg/m2）;第4组，高血清白蛋白水平和高BMI。主要结局是估计肾小球滤过率（eGFR）下降30%或2年内开始透析。次要结果是每年GFR下降（mL/min/1.73 m2/year）。结果根据基线特征（参考，第4组）调整的Logistic回归分析显示，只有第1组与CKD进展的显著风险相关，调整后的比值比为3.51 [95%置信区间（CI）（1.63，7.56）]。校正基线特征后的多元线性回归分析显示，第1组和第4组之间的eGFR年下降率存在显著差异[系数β（标准误）-2.62（0.75），p = 0.001]。
Background The relationship between protein-energy wasting and chronic kidney disease (CKD) progression is unknown. In the present prospective cohort study, we evaluated the hypothesis that a combination of low body mass index (BMI) and serum albumin level is associated with rapid CKD progression.Methods The study cohort comprised 728 predialysis Japanese patients with CKD (stages 2-5) enrolled from 2010 to 2011. Patients were categorized into four groups according to their serum albumin levels and BMI: group 1, low serum albumin level (= 23.5 kg/m(2)); and group 4, high serum albumin level and high BMI. The primary outcome was a 30 % decline in estimated glomerular filtration rate (eGFR) or start of dialysis within 2 years. The secondary outcome was an annual GFR decline (mL/min/1.73 m(2)/year).Results Logistic regression analysis adjusted for baseline characteristics (reference, group 4) showed that only group 1 was associated with a significant risk of CKD progression, with adjusted odds ratio of 3.51 [95 % confidence interval (CI) (1.63, 7.56)]. A multivariate linear regression analysis adjusted for baseline characteristics showed a significant difference in annual eGFR decline between groups 1 and 4 [coefficients beta (standard error) -2.62 (0.75), p = 0.001].Conclusion This study suggests that combined effects of low BMI (