Association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes
Association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes
复制标题
心脏手术后急性肾损伤患者矿物质和骨骼疾病之间的关联以及不良后果
DOI：
10.1186/s12882-019-1572-y
复制
发表时间：
2019-10
期刊：
影响因子：
--
通讯作者：
Feng Ding
中科院分区：
文献类型：
--
作者：
Tianye Yang;Wenji Wang;Xiao Tang;Peng Shi;Lulu Zhang;Wenyan Yu;Yingxin Xie;Daqiao Guo;Feng Ding
背景大量研究评估了慢性肾脏病（CKD）和终末期肾脏病（ESRD）患者中矿物质和骨骼疾病的患病率和重要性。然而，鲜为人知的是矿物质和骨代谢失调，在急性肾损伤（阿基）。MethodsWe评估了矿物质和骨代谢产物和临床结果之间的关联，在158例患者接受心脏手术，并在2014年6月和2016年1月之间发展阿基。记录患者的基线特征，并检测矿物质和骨代谢产物的水平，包括钙、磷酸盐、全段甲状旁腺激素（iPTH）、25-羟基维生素D（25 D）、骨特异性碱性磷酸酶（BAP）、抗酒石酸酸性磷酸酶5 b在确诊后12 h内检测血清TRACP-5 b和C-末端成纤维细胞生长因子23（cFGF 23）水平。iPTH和cFGF 23水平与28天死亡率显著相关（磷酸盐：风险比[HR] =2.620，95% CI：1.083至6.338，p = 0.035; iPTH：HR = 1.044，95% CI：1.001至1.090，p = 0.046; cFGF 23：HR = 1.367，95% CI：1.168 ~ 1.599，p < 0.001）。此外，较高的血清cFGF 23和BAP水平与不良结局风险增加独立相关。此外，我们发现血清cFGF 23水平升高最显著，并与阿基的严重程度相关（P< 0.001）。结论矿物质和骨代谢产物失调，并与阿基患者的不良临床结局相关。registrationwww.clinicaltrials.gov NCT 00953992。2009年8月6日注册。
BackgroundNumerous studies have evaluated the prevalence and importance of mineral and bone disorders among patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). However, little is known about dysregulated mineral and bone metabolism in acute kidney injury (AKI).MethodsWe evaluated the association between mineral and bone metabolites and clinical outcomes in 158 patients who underwent cardiac surgery and developed AKI between June 2014 and January 2016. The baseline characteristics of the patients were recorded, and the levels of mineral and bone metabolites, including calcium, phosphate, intact parathyroid hormone (iPTH), 25-hydroxyvitamin D (25D), bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRACP-5b) and C-terminal fibroblast growth factor 23 (cFGF23) were measured within 12 h after establishing the clinical diagnosis.ResultsThe serum phosphate, iPTH and cFGF23 levels were significantly associated with the 28-day mortality (phosphate: Hazard Ratio [HR] =2.620, 95% CI: 1.083 to 6.338,p= 0.035; iPTH: HR = 1.044, 95% CI: 1.001 to 1.090,p= 0.046; cFGF23: HR = 1.367, 95% CI: 1.168 to 1.599,p< 0.001). Moreover, higher serum cFGF23 and BAP levels were independently associated with an increased risk of adverse outcomes. Additionally, we found that the serum cFGF23 levels rose most significantly and were associated with the severity of AKI (P< 0.001).ConclusionsMineral and bone metabolites are dysregulated and are associated with adverse clinical outcomes among patients with AKI.Trial registrationwww.clinicaltrials.gov NCT 00953992. Registered 6 August 2009.
登录
查看更多内容
影响因子：
13.6
作者：
Leaf, David E.;Jacob, Kirolos A.;Waikar, Sushrut S.
通讯作者：
Waikar, Sushrut S.
影响因子：
5.3
作者：
通讯作者：
--
影响因子：
3.2
作者：
Leaf DE;Waikar SS;Wolf M;Cremers S;Bhan I;Stern L
通讯作者：
Stern L
影响因子：
38.9
作者：
Druml, Wilfred;Lenz, Kurt;Laggner, Anton N.
通讯作者：
Laggner, Anton N.
影响因子：
19.6
作者：
Leaf DE;Christov M;Jüppner H;Siew E;Ikizler TA;Bian A;Chen G;Sabbisetti VS;Bonventre JV;Cai X;Wolf M;Waikar SS
通讯作者：
Waikar SS