Association between the Achievement of Target Range CKD-MBD Markers and Mortality in Prevalent Hemodialysis Patients in Taiwan by Using the Kidney Disease: Improving Global Outcomes Clinical Guidelines.
Association between the Achievement of Target Range CKD-MBD Markers and Mortality in Prevalent Hemodialysis Patients in Taiwan by Using the Kidney Disease: Improving Global Outcomes Clinical Guidelines.
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DOI：
10.1155/2016/1523124
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发表时间：
2016
影响因子：
--
通讯作者：
Chen JB
中科院分区：
文献类型：
--
作者：
Liu Y;Lee WC;Cheng BC;Li LC;Lee CH;Chang WX;Chen JB
背景资料。本研究评估台湾血液透析(HD)患者达到慢性肾脏疾病-矿物质与骨病(CKD-MBD)标记物的目标水平与死亡率之间的关系。目标水平基于肾脏疾病：改善全球结果(KDIGO)指南。方法：研究方法。我们对2009至2013年间的1126名HD患者进行了回顾性病历回顾。Logistic回归模型用于评估达到目标标记物水平与全因和心血管(CV)死亡风险之间的关系。参考目标范围为7.9≤钙(Ca)≤9.9 mg/dL，2.4≤磷酸(P)≤4.7 mg/dL，144≤完整甲状旁腺素≤648 pg/ml。结果。与达到目标钙或甲状旁腺素水平相比，达到目标磷水平与全因死亡率风险较低相关。达到目标P+iPTH水平(OR 1.32)与达到目标Ca+P(OR 1.66)和Ca+iPTH(OR 1.43)相比，全因死亡率的优势比更低。心血管死亡风险也观察到了类似的趋势。结论。目前的研究表明，达到KDIGO目标范围内的血清P水平是降低HD患者死亡率的最重要因素。
Background. This study evaluated the association between achieving target chronic kidney disease-mineral and bone disorder (CKD-MBD) marker levels and mortality in Taiwanese hemodialysis (HD) patients. Target levels were based on the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Methods. We performed a retrospective medical record review of 1126 HD patients between 2009 and 2013. A logistic regression model was used to evaluate the relationship between achieving target marker levels and the risk for all-cause and cardiovascular (CV) mortality. Reference target ranges were 7.9 ≤ calcium (Ca) ≤ 9.9 mg/dL, 2.4 ≤ phosphate (P) ≤ 4.7 mg/dL, and 144 ≤ intact parathyroid hormone (iPTH) ≤ 648 pg/mL. Results. Achievement of target P levels was associated with a lower risk for all-cause mortality compared to achievement of either target Ca or iPTH levels. Achieving target P + iPTH levels (OR 1.32) was associated with a lower odds ratio for all-cause mortality compared to achieving target Ca + P (OR 1.66) and Ca + iPTH (OR 1.43) levels. Similar trends were observed for CV mortality risk. Conclusions. The present study demonstrated that achieving serum P levels within the KDIGO target range is the most important factor for lowering mortality in HD patients.
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影响因子：
2.3
作者：
Kong X;Zhang L;Zhang L;Chen N;Gu Y;Yu X;Liu W;Chen J;Peng L;Yuan W;Wu H;Chen W;Fan M;He L;Ding F;Chen X;Xiong Z;Zhang J;Jia Q;Shi W;Xing C;Tang X;Hou F;Shu G;Mei C;Wang L;Xu D;Ni Z;Zuo L;Wang M;Wang H
通讯作者：
Wang H
DOI：
10.1038/ki.2009.188
发表时间：
2009-08-01
期刊：
Kidney international. Supplement
影响因子：
--
作者：
通讯作者：
--
DOI：
10.1097/01.asn.0000113243.24155.2f
发表时间：
2004-03-01
影响因子：
13.6
作者：
Stevens, LA;Djurdjev, O;Levin, A
通讯作者：
Levin, A
影响因子：
19.6
作者：
Kalantar-Zadeh, K.;Kuwae, N.;Kopple, J. D.
通讯作者：
Kopple, J. D.
影响因子：
3
作者：
Cozzolino, Mario;Messa, Piergiorgio;Mazzaferro, Sandro
通讯作者：
Mazzaferro, Sandro