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AJKD：上臂中部周径下降与血液透析患者的全因死亡率和心血管事件明显相关

2013-07-22 MedSci AJKD

全因死亡透析
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一项Hemodialysis（HEMO）研究发现，上臂中部周径（MAC）下降与血液透析（HD）患者的全因死亡率和心血管事件明显相关，这种相关性在体重指数（BMI）低的患者中更加显着（BMI≤25）。该研究由新墨西哥大学Mark L. Unruh和同事完成，已在线发表于American Journal of Kidney Diseases 研究概述 研究共纳入1846名HD患者，观察两项营养状态

一项Hemodialysis（HEMO）研究发现，上臂中部周径（MAC）下降与血液透析（HD）患者的全因死亡率和心血管事件明显相关，这种相关性在体重指数（BMI）低的患者中更加显着（BMI≤25）。该研究由新墨西哥大学Mark L. Unruh和同事完成，已在线发表于American Journal of Kidney Diseases

研究概述

研究共纳入1846名HD患者，观察两项营养状态指标——MAC和皮褶厚度的变化与全因死亡率、心血管事件死亡、住院及感染相关死亡的关联。该研究中位随访时间为2.5年，期间发生死亡845例患者MAC和皮褶厚度下降分为0.26厘米和1.1毫米/年。

BMI低的患者中，每年MAC下降1cm将导致HD患者全因死亡率增加2.4倍；在BMI＞25的患者中，二者无明显相关性。不管BMI高低，每年MAC下降1cm可导致心血管死亡和住院分别增加54%和47%。在BMI低的患者中，感染相关死亡增加5倍。在BMI低的患者中，皮褶厚度每降低1mm，全因死亡率增加22%，感染相关死亡增加83%。

研究者指出，高 BMI在透析患者被认为是一个生存的保护性指标，这曾被称为“肥胖悖论”。营养状况不良与透析患者生存率有关。BMI≤25的患者，肌肉含量和身体脂肪的下降可能会影响死亡风险；而在超重或肥胖的HD患者中，没有观察到上述关系。

原始出处：

Su CT, Yabes J, Pike F, Weiner DE, Beddhu S, Burrowes JD, Rocco MV, Unruh ML.Changes in Anthropometry and Mortality in Maintenance Hemodialysis Patients in the HEMO Study.Am J Kidney Dis. 2013 Jul 13. doi:pii: S0272-6386(13)00910-4. 10.1053/j.ajkd.2013.05.015.

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    2013-10-01 hukaixun

    #血管事件#

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    2013-07-24 医者仁心

    #全因死亡率#

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    2013-07-24 habb

    #血液透析#

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    2013-07-24 ewsr6

    #透析患者#

    0

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