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BMJ:性别对慢性肾病患者死亡率的影响

2021-11-17 MedSci原创 MedSci原创

女性肾衰竭患者的预后更差,表现为死亡率高,生存率低以及寿命损失年较多

慢性肾病(CKD)的定义为患者肾功能下降,肾小球滤过率低于60 mL/min/1.73 m2或肾损伤指征持续时间至少3个月。2017年统计数据显示,CKD患病率约为9.1%,是排名第12位的死亡因素,每年直接导致120万患者死亡,140万人死于CKD相关疾病。随着慢性肾病进展,当肾小球滤过率低于15 mL/min/1.73 m2时即为肾衰竭,其治疗手段包括透析、肾移植或姑息治疗。近日研究人员考察了性别因素对肾衰竭患者死亡率的影响。

本次研究为基于人群的队列研究,收集1980-2019年间澳大利亚和新西兰透析和移植登记处数据,与国家死亡人口登记数据相关联。总计包含82844 例肾衰竭患者,其中女性33329 例(40%),男性49555 例(60%)。死亡49376 例,其中女性患者20099 例;男性患者29277 例,共随访536602 人-年。研究的主要终点为标准化死亡率、相对生存率和寿命损失年数,并根据透析方式和肾移植与否进行分层。

总体上男性和女性肾衰患者的预后差异不大,但与一般人群相比,肾功能衰竭女性患者的全因死亡率高于男性患者(女性患者:标准化死亡率11.3,预期死亡1781人,观察实际死亡20099人;男性患者:标准化死亡率6.9,预期死亡4272人,实际观察到死亡29277人)。女性患者的相对生存率也较低,调整后的额外死亡率高出11%。与所有年龄段的男性患者相比,女性肾衰竭患者的平均寿命损失年数为3.6年。血液透析和腹膜透析患者的性别死亡率差异不显著。肾移植降低了但没有完全消除额外死亡率的性别差异,肾移植后女性患者的相对生存率与男性相当,寿命损失年数差异降低至2.3年。

肾脏代替治疗或肾移植对肾衰竭患者寿命损失的影响

研究发现,女性肾衰竭患者的预后更差,表现为死亡率高,生存率低以及寿命损失年较多

原始出处:

Nicole L De La Mata et al. Sex differences in mortality among binational cohort of people with chronic kidney disease: population based data linkage study.BMJ. 16 November, 2021.

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    2022-09-08 gaoxiaoe
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    2022-01-26 醫着仁心

    很好

    0

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