Ultrafiltration rate adjusted to body weight and mortality in hemodialysis patients
Ultrafiltration rate adjusted to body weight and mortality in hemodialysis patients
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DOI：
10.1016/j.nefro.2020.10.007
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发表时间：
2021-07-01
期刊：
影响因子：
2.6
通讯作者：
Gonzalez-Parra, Emilio
中科院分区：
文献类型：
--
作者：
Fernandez-Prado, Raul;Pena-Esparragoza, Jessy Korina;Gonzalez-Parra, Emilio
背景和目的：血液透析患者的死亡率仍然很高。根据体重调整的超滤率（UFR/W）升高与低血压、死亡和/或心血管事件的高风险相关。方法：我们评估了215例血液透析患者的UFR/W与死亡率之间的关系。平均随访28±6.12个月。我们在整个随访过程中收集了患者的基线特征和平均UFR/W。结果：平均UFR/W分别为9.0 +/- 2,4和7.1 ~ 10.1 mL/kg/h。我们根据UFR/W超过文献中描述的与死亡率增加相关的限制（10.0 ml/kg/h和13.0 ml/kg/h）的时段百分比对人群进行分组。UFR/W较高的患者更年轻，透析期间体重增加和减轻百分比较高，但干体重、透析前和透析后体重较低。在整个随访过程中，46例（21.4%）患者死亡，其中大多数超过70岁，患有糖尿病或心血管疾病。两组之间的死亡率没有差异，死亡患者和未死亡患者的UFR/W也没有差异。与之前的研究相反，我们没有发现UFR/W与死亡率之间的关联，这可能是由于心血管保护药物的使用较高而UFR/W较低。结论：在体重较轻的年轻患者中观察到最高的UFR/W，与死亡率增加无关。(C) 2021西班牙神经科学学会。Elsevier Espana， S.L.U.出版
Background and aims: Mortality among hemodialysis patients remains high. An elevated ultrafiltration rate adjusted by weight (UFR/W) has been associated with hypotension and higher risk of death and/or cardiovascular events.Methods: We evaluated the association between UFR/W and mortality in 215 hemodialysis patients. The mean follow-up was 28 +/- 6.12 months. We collected patients' baseline characteristics and mean UFR/W throughout the follow-up.Results: Mean UFR/W was 9.0 +/- 2,4 and tertiles 7.1 y 10.1 mL/kg/h. We divided our population according to the percentage of sessions with UFR/W above the limits described in the literature associated with increased mortality (10.0 ml/kg/h and 13.0 mL/kg/h). Patients with higher UFR/W were younger, with higher interdialytic weight gain and weight reduction percentage but lower dry, pre and post dialysis weight. Throughout the follow-up, 46 (21.4%) patients died, the majority over 70 years old, diabetic or with cardiovascular disease. There were neither differences regarding mortality between groups nor differences in UFR/W among patients who died and those who did not. Contrary to previous studies, we did not find an association between UFR/W and mortality, maybe due to a higher prevalence in the use of cardiovascular protection drugs and lower UFR/W.Conclusions: The highest UFR/W were observed in younger patients with lower weight and were not associated with an increased mortality. (C) 2021 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.