Early combination of pulmonary vasodilators prevents chronic kidney disease progression in connective tissue disease‐associated pulmonary hypertension
Early combination of pulmonary vasodilators prevents chronic kidney disease progression in connective tissue disease‐associated pulmonary hypertension
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早期联合使用肺血管扩张剂可预防结缔组织病相关肺动脉高压的慢性肾病进展
DOI：
10.1111/1756-185x.14225
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发表时间：
2021
影响因子：
2.5
通讯作者：
Takeuchi Tsutomu
中科院分区：
文献类型：
--
作者：
Hanaoka Hironari;Ishigaki Sho;Takei Hiroshi;Hiramoto Kazuoto;Saito Shuntaro;Kondo Yasushi;Kikuchi Jun;Kaneko Yuko;Takeuchi Tsutomu
目的肺动脉高压（PH）和慢性肾脏病（CKD）的发生、发展和加重相互依赖.我们评估了PH对结缔组织病（CTD）相关PH患者CKD进展的影响。MethodsWe回顾了我院经右心导管（RHC）检查诊断为PH的连续CTD患者。根据血管扩张剂的使用将患者分为2组：单药治疗或联合治疗。我们将接受联合治疗的患者进一步分为早期和非早期联合治疗组。早期联合用药定义为在开始使用第一种药物后1个月内添加第二种血管扩张剂。血液动力学和CKD进展的临床过程进行了compared.Results38例患者被纳入分析：10例单药治疗和28与联合治疗（14与早期和14与非早期）。在基线时，接受联合治疗的患者的平均肺动脉压（RHC）和右心室收缩压（RVSP）（超声心动图）显著较高（P= 0.04），治疗后RVSP的改善程度大于接受单药治疗的患者。接受联合治疗的患者中CKD进展的发生率显著低于接受单药治疗的患者（P= 0.05）。在接受联合治疗的患者中，早期联合治疗组的CKD进展发生率低于非早期联合治疗组（P= 0.03）。
AimPulmonary hypertension (PH) and chronic kidney disease (CKD) are interdependent for their development and exacerbation. We evaluated the effect of PH on CKD progression in patients with connective tissue disease (CTD)‐associated PH.MethodsWe reviewed consecutive patients with CTD who were diagnosed with PH with right heart catheter (RHC) examinations in our hospital. Patients were divided into 2 groups according to the use of vasodilators: monotherapy or combination therapy. We further divided the patients with combination therapy into early and non‐early combination groups. Early combination was defined as the addition of the second vasodilator within 1 month after starting the first drug. The clinical course of hemodynamics and CKD progression were compared.ResultsThirty‐eight patients were included in the analysis: 10 were treated with monotherapy and 28 with combination therapy (14 with early and 14 with non‐early). At baseline, patients who received combination therapy had a significantly higher mean pulmonary arterial pressure with RHC and a higher right ventricular systolic pressure (RVSP) with echocardiography (P= .04) and showed a greater improvement in RVSP after treatment than those who underwent monotherapy. The incidence of CKD progression was significantly lower in patients who received combination therapy than in those who received monotherapy (P= .05). Among patients who received combination therapy, the early combination group had a lower incidence of CKD progression than the non‐early combination group (P= .03).ConclusionsEarly combination therapy is associated with a lower incidence of CKD progression in patients with CTD‐associated PH.
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影响因子：
3.9
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
Pokroy-Shapira, Elisheva;Gelernter, Ilana;Molad, Yair
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