Effect of Renal Insufficiency on Cardiovascular Outcomes

描述(来自应用程序的逐字)：心血管疾病帐户 在接受维持性治疗的患者中，报告的死亡人数几乎有一半 透析。因为突发的透析患者通常患有晚期冠脉 与患者相比不太容易治疗的动脉疾病 肾功能正常，治疗效果最大 通过发明在肾功能不全患者中，在他们的 终末期肾病的发展及冠状动脉发育的早期 损伤。这项提案将定义不同程度的慢性病的影响 肾功能不全对慢性肾功能不全患者五年生存率的影响 冠状动脉疾病。这项研究将进一步比较患者的存活率 接受冠状动脉疾病治疗(内科、经皮冠状动脉介入治疗 冠状动脉介入治疗和冠状动脉旁路移植术) 轻、中、重度肾功能不全。在评估了这些临床数据之后 结果，这项提案将估计五年的累积医疗资源 病人的使用率(再住院和心脏手术)和费用 慢性肾功能不全和严重的冠状动脉疾病 比较主要患者亚组之间的成本。回溯性队列设计将 被用来利用杜克心血管疾病数据库 (DDCD)，这是一个由公爵维护的大型、全面的患者数据库 临床研究所(DCRI)及其附属医院和医生 管理数据库。这项研究将检查心血管疾病的结果 影响慢性肾功能不全患者的生存和 接受慢性透析的患者。这项研究的结果将提供 终末期肾病前期慢性病人群早期干预的证据 改善肾功能不全最大限度提高冠脉病变疗效 血运重建和提高存活率。

DESCRIPTION (Verbatim from the application): Cardiovascular disease accounts for almost half of the reported deaths for patients receiving maintenance dialysis. Because incident dialysis patients often have advanced coronary artery disease that is less amenable to treatment as compared with patients with normal renal function, the greatest impact of therapy will be obtained through invention among patients with renal insufficiency, prior to their development of ESRD and earlier in the development of the coronary artery lesions. This proposal will define the impact of varying degrees of chronic renal insufficiency on five-year survival among patients with significant coronary artery disease. This study will further compare patient survival following treatment for coronary artery disease (medical, percutaneous coronary artery intervention and coronary artery bypass grafting) among patients with mild, moderate, and severe renal insufficiency. After evaluating these clinical outcomes, this proposal will estimate the cumulative five-year medical resource utilization (rehospitalizations and cardiac procedures) and costs for patients with chronic renal insufficiency and significant coronary artery disease to compare costs among major patient subgroups. A retrospective cohort design will be used to take advantage of the Duke Databank for Cardiovascular Diseases (DDCD), a large, comprehensive patient database, maintained by the Duke Clinical Research Institute (DCRI) and its associated hospital and physician administrative databases. This study will examine the cardiovascular outcomes that affect the survival of patients with chronic renal insufficiency and patients receiving chronic dialysis. The results of this study will provide evidence for early intervention among the pre-ESRD population with chronic renal insufficiency to improve maximize the efficacy of coronary revascularization and improve survival.