Dysnatremias, Mortality, and Kidney Failure in CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.
Dysnatremias, Mortality, and Kidney Failure in CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.
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DOI：
10.1016/j.xkme.2022.100554
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发表时间：
2022-12
期刊：
影响因子：
3.9
通讯作者：
CRIC Investigators, C. R. I. C. Investigators
中科院分区：
文献类型：
--
作者：
Hassanein, Mohamed;Arrigain, Susana;Schold, Jesse D.;Nakhoul, Georges N.;Navaneethan, Sankar D.;Mehdi, Ali;Sekar, Arjun;Tabbara, Jad;Taliercio, Jonathan J.;CRIC Investigators, C. R. I. C. Investigators
在慢性肾脏病（CKD）人群中，血钠异常与死亡风险增加相关。我们的目的是确定CKD人群中与血钠代谢障碍相关的患病率和风险因素，并评估慢性肾功能不全队列研究中CKD患者血钠代谢障碍与肾衰竭和死亡率的相关性。前瞻性队列研究分析。来自慢性肾功能不全队列研究的21-74岁成人CKD患者。基线和时间依赖性低钠血症和高钠血症。全因死亡率和肾衰竭。使用分类变量的χ2检验、年龄的方差分析和实验室变量的Kruskal-Wallis检验比较基线特征。采用考克斯比例风险模型和竞争风险模型评价基线钠水平与总体死亡率之间的相关性。在总计5，444例CKD患者中，486例（9%）患有低钠血症，53例（1%）患有高钠血症。总共有1,508名患者死亡，1,206名患者出现肾衰竭。在校正的考克斯模型中，时间依赖性血钠失调与低钠血症（HR，1.38; 95% CI，1.16-1.64）和高钠血症（HR，1.54; 95% CI，1.04-2.29）的死亡率密切相关。与低钠血症相关的因素包括女性、糖尿病和高血压。不考虑年龄，时间依赖性高钠血症与肾衰竭风险增加相关（HR，1.64; 95% CI，1.06-2.53）。基线和时间依赖性低钠血症与65岁以下患者肾衰竭风险增加相关（基线低钠血症HR，1.30; 95% CI，1.03-1.64和时间依赖性低钠血症HR，1.36; 95% CI，1.09-1.70），但与年龄>65岁的患者无关。无法确定因果关系，且对住院患者缺乏普遍性。钠代谢障碍在非卧床CKD患者中普遍存在，并与死亡率和肾衰竭相关。时间依赖性血钠代谢异常与CKD患者的死亡率显著相关。时间依赖性高钠血症与进展为肾衰竭相关。基线和时间依赖性低钠血症与65岁以下患者进展为肾衰竭的风险增加相关。
Dysnatremias have been associated with an increased risk of mortality in the chronic kidney disease (CKD) population. Our objective is to identify the prevalence of and risk factors associated with dysnatremias in a CKD population and assess the association of dysnatremias with kidney failure and mortality among patients with CKD enrolled in the Chronic Renal Insufficiency Cohort Study. Analysis of prospective cohort study. Adult patients aged 21-74 years with CKD from the Chronic Renal Insufficiency Cohort study. Baseline and time-dependent hyponatremia and hypernatremia. All-cause mortality and kidney failure. Baseline characteristics were compared using χ2 tests for categorical variables, analysis of variance for age, and Kruskal-Wallis tests for laboratory variables. Cox proportional hazards models and competing risk models were used to evaluate the association between baseline sodium level and overall mortality. Of a total of 5,444 patients with CKD, 486 (9%) had hyponatremia and 53 (1%) had hypernatremia. Altogether, 1,508 patients died and 1,206 reached kidney failure. In adjusted Cox models, time-dependent dysnatremias were strongly associated with mortality for both hyponatremia (HR, 1.38; 95% CI, 1.16-1.64) and hypernatremia (HR, 1.54; 95% CI, 1.04-2.29). Factors associated with hyponatremia included female sex, diabetes, and hypertension. Regardless of age, time-dependent hypernatremia was associated with an increased risk of kidney failure (HR, 1.64; 95% CI, 1.06-2.53). Baseline and time-dependent hyponatremia were associated with an increased risk of kidney failure in patients younger than 65 (baseline hyponatremia HR, 1.30; 95% CI, 1.03-1.64 and time-dependent hyponatremia HR, 1.36; 95% CI, 1.09-1.70) but not among patients aged >65 years. Inability to establish causality and lack of generalizability to hospitalized patients. Dysnatremias are prevalent among ambulatory CKD patients and are associated with mortality and kidney failure. Time-dependent dysnatremias were significantly associated with mortality in patients with CKD. Time-dependent hypernatremia was associated with progression to kidney failure. Baseline and time-dependent hyponatremia were associated with an increased risk of progression to kidney failure in those younger than 65 years.
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DOI：
10.2215/cjn.04260415
发表时间：
2015-11-01
影响因子：
9.8
作者：
Denker, Matthew;Boyle, Suzanne;Feldman, Harold I.
通讯作者：
Feldman, Harold I.
影响因子：
3.7
作者：
Corona, Giovanni;Giuliani, Corinna;Peri, Alessandro
通讯作者：
Peri, Alessandro
影响因子：
4.2
作者：
Han, Sang-Woong;Tilea, Anca;Saran, Rajiv
通讯作者：
Saran, Rajiv
影响因子：
3.7
作者：
Khan YH;Sarriff A;Adnan AS;Khan AH;Mallhi TH
通讯作者：
Mallhi TH
影响因子：
2.5
作者：
Chiu, Diana Yuan Yng;Kalra, Philip A.;Green, Darren
通讯作者：
Green, Darren