Optimal cut-off threshold in pulse pressure predicting cardiovascular death among newly diagnosed end-stage renal disease patients A prospective cohort study
Optimal cut-off threshold in pulse pressure predicting cardiovascular death among newly diagnosed end-stage renal disease patients A prospective cohort study
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新诊断终末期肾病患者脉压预测心血管死亡的最佳截止阈值一项前瞻性队列研究
DOI：
10.1097/md.0000000000016340
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发表时间：
2019
期刊：
影响因子：
1.6
通讯作者：
Zhao Zhanzheng
中科院分区：
文献类型：
--
作者：
Wang Zheng;Yu Dahai;Cai Yamei;Zhao Bin;Zhang Xiaoxue;Zhao Zhanzheng
心血管疾病（CVD）是终末期肾病（ESRD）透析治疗患者死亡的主要原因。脉压（PP）作为心血管危险的独立预后因素在临床上可能与预测ESRD患者心血管疾病导致的短期死亡有关。本研究旨在探讨初始腹膜透析（PD）患者PP与心血管死亡风险之间的剂量反应关系。2007年至2014年间在河南省腹膜透析登记处（HPDR）登记的所有患者都纳入了当前的队列研究。PP通过PD初始化的日期进行评估，并将PD初始化后2年内的心血管死亡率定义为结果。所有可获得的临床测量数据均被筛选为协变量。使用样条模型进一步探讨了PP与风险之间的剂量-反应关系。PP与心血管疾病2年死亡风险呈非线性关系（P< 0.05）。001为线性测试)。与心血管死亡最低风险相关的PP为61 (95% CI 56-64) mmHg。在初始化PD的ESRD患者中，PP是短期心血管死亡风险的良好预后因素。PP值为56 - 64 mmHg时，风险最低。
Cardiovascular disease (CVD) is the leading cause of death in patients with end-stage renal disease (ESRD) treated by dialysis. Pulse pressure (PP) as an independent prognostic factor of cardiovascular risk might be clinically implicated in predicting the short-term deaths due to cardiovascular diseases in ESRD patients. This study aimed to investigate the dose-response association between PP and risk of cardiovascular mortality in patients initializing peritoneal dialysis (PD). All patients registered with the Henan Peritoneal Dialysis Registry (HPDR) between 2007 and 2014 were incorporated in the current cohort study. PP was assessed by the date of initialisation of PD and cardiovascular mortality in 2 years after the initialisation of PD was defined as the outcome. All accessible clinical measurements were screened as covariables. Further dose–response relationships between PP and risks were explored using spline models. There was a non-linear relationship between PP and the risk of 2-year death for a cardiovascular diseases (P<. 001 for linearity test). The PP associated with the lowest risk of cardiovascular mortality was 61 (95% CI 56–64) mmHg. In ESRD patients initializing PD, PP is a good prognostic factor of risk of short-term cardiovascular mortality. The risk is lowest with a PP of 56 to 64 mmHg.