Malnutrition and inflammation determine prognosis of patients with CRS type4
Malnutrition and inflammation determine prognosis of patients with CRS type4
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营养不良和炎症决定4型CRS患者的预后
DOI：
10.1159/000322408
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发表时间：
2011
影响因子：
3
通讯作者：
Sugimoto T
中科院分区：
文献类型：
--
作者：
Mimura I;Nishi H;Nishi T;Mise N;Sugimoto T
背景/目的：相当数量的尿毒症患者在开始血液透析(HD)之前就发生了缺血性心脏病。最近，透析前患者的慢性心肾综合征已被认识到。然而，对于这一亚组HD患者的预后因素知之甚少。方法：1984-2003年间，三井纪念医院共收治87例HD患者，这些患者被归类为心肾综合征4型(慢性心肾综合征)。结果：死亡25例，5年生存率约75%。血清白蛋白水平较低(p=0.03)或C-反应蛋白水平较高(p=0.02)的患者全因死亡率和年龄性别调整死亡率均较高。结论：有缺血性心脏病病史的HD患者在透析开始时营养不良和炎症反应预示着低存活率。
Background/Aims:A significant number of uremic patients develop ischemic heart disease before hemodialysis (HD) is initiated. Recently, chronic cardiorenal syndrome among predialysis patients has been recognized. However, little is known about prognostic factors in this subgroup of incident HD patients.Methods:A total of 87 incident HD patients, who were classified into cardiorenal syndrome type 4 (chronic cardiorenal syndrome), were identified at Mitsui Memorial Hospital between 1984 and 2003. The survival and risk factors for mortality were examined.Results:25 patients died and the 5-year survival rate amounted to approximately 75%. Both all-cause mortality and the adjusted mortality for age and sex were higher in patients with a lower serum albumin level (p = 0.03) or higher serum C-reactive protein level (p = 0.02).Conclusion:The poor survival rate of incident HD patients with a medical history of ischemic heart disease was predicted by malnutrition and inflammation at the start of HD.