Rapid fluid removal during dialysis is associated with cardiovascular morbidity and mortality.
Rapid fluid removal during dialysis is associated with cardiovascular morbidity and mortality.
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DOI：
10.1038/ki.2010.383
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发表时间：
2011-01
影响因子：
19.6
通讯作者：
Brunelli, Steven M.
中科院分区：
文献类型：
--
作者：
Flythe, Jennifer E.;Kimmel, Stephen E.;Brunelli, Steven M.
接受血液透析的患者心血管发病率和死亡率高，这可能与快速超滤对血液动力学的影响有关。在这里，我们测试了更高的透析超滤率是否与更高的全因死亡率和心血管死亡率以及心血管疾病住院率相关。我们使用的数据来自血液透析研究，这是一项近7年的随机临床试验，共有1846名患者接受每周三次的慢性透析。超滤速率分为10 ml/h/kg、10 - 13 ml/h/kg和13 ml/h/kg以上三种。与超滤率最低的组相比，超滤率最高的组与全因死亡率和心血管相关死亡率的增加显著相关，调整后的危险比分别为1.59和1.71。总体而言，超滤率在10 - 13ml /h/kg之间与全因死亡率或心血管死亡率无关；然而，它们与充血性心力衰竭的参与者显著相关。三次样条插值表明，无论充血性心力衰竭状态如何，超滤率超过10 ml/h/kg时，全因死亡率和心血管死亡率的风险开始增加。因此，血液透析患者的超滤率越高，全因死亡和心血管死亡的风险越大。
Patients receiving hemodialysis have high rates of cardiovascular morbidity and mortality that may be related to the hemodynamic effects of rapid ultrafiltration. Here we tested whether higher dialytic ultrafiltration rates are associated with greater all-cause and cardiovascular mortality, and hospitalization for cardiovascular disease. We used data from the Hemodialysis Study, an almost-7-year randomized clinical trial of 1846 patients receiving thrice-weekly chronic dialysis. The ultrafiltration rates were divided into three categories: up to 10 ml/h/kg, 10–13 ml/h/kg, and over 13 ml/h/kg. Compared to ultrafiltration rates in the lowest group, rates in the highest were significantly associated with increased all-cause and cardiovascular-related mortality with adjusted hazard ratios of 1.59 and 1.71, respectively. Overall, ultrafiltration rates between 10–13 ml/h/kg were not associated with all-cause or cardiovascular mortality; however, they were significantly associated among participants with congestive heart failure. Cubic spline interpolation suggested that the risk of all-cause and cardiovascular mortality began to increase at ultrafiltration rates over 10 ml/h/kg regardless of the status of congestive heart failure. Hence, higher ultrafiltration rates in hemodialysis patients are associated with a greater risk of all-cause and cardiovascular death.
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影响因子：
15.9
作者：
LILLEY, JJ;GOLDEN, J;STONE, RA
通讯作者：
STONE, RA
影响因子：
13.2
作者：
Sharp, J;Wild, MR;Deighan, CJ
通讯作者：
Deighan, CJ
影响因子：
37.8
作者：
Shroff, Rukshana C.;McNair, Rosamund;Shanahan, Catherine M.
通讯作者：
Shanahan, Catherine M.
影响因子：
19.6
作者：
Shoji, T;Tsubakihara, Y;Imai, E
通讯作者：
Imai, E
DOI：
10.1016/s0735-1097(99)00467-2
发表时间：
1999-12-01
影响因子：
24
作者：
Shivalkar, B;Flameng, W;Vanhaecke, J
通讯作者：
Vanhaecke, J