BACKGROUND:There is a lack of information on stiffness parameter β, an index of arterial stiffness, in hemodialysis (HD) patients. The aim of the present study was to investigate whether stiffness parameter β is predictive of the long-term mortality of chronic HD patients. METHODS:We measured biochemical parameters and the stiffness parameter β of 80 patients on maintenance HD therapy and followed their course for 4 years, and we enrolled 70 of these 80 patients in the study. We divided the 70 patients into tertiles according to their stiffness parameter β values, and conducted multivariate analyses to examine the impact of the tertiles on 4-year mortality. RESULTS:Older age and the presence of diabetes mellitus were found to be independently associated with higher stiffness parameter β values. Fifteen patients (21.4 %) died and 16 (22.9 %) experienced a new cardiovascular event during the follow-up period. The results of a Kaplan-Meier analysis revealed a significantly higher risk of all-cause mortality in the HD patients with highest stiffness parameter β values (p = 0.0106). According to the ROC curve, the cut-off level that yielded maximal sensitivity and specificity for predicting all-cause mortality was 10.1, and the sensitivity and specificity using the cut-off value were 69.2 and 70.2 %, respectively. CONCLUSION:The results of this study suggest that stiffness parameter β is a predictor of all-cause mortality in chronic HD patients.

译文

背景:在血液透析(HD)患者中,缺乏关于刚度参数β(动脉刚度指标)的信息。本研究的目的是研究刚度参数β是否可预测慢性HD患者的长期死亡率。
方法:我们测量了维持HD治疗的80例患者的生化参数和刚度参数β,并对其病程进行了为期4年的研究,我们在这80名患者中招募了70名患者。我们根据其刚度参数β值将70例患者分为三分位数,并进行多变量分析以检查三分位数对4年死亡率的影响。
结果:老年人年龄和糖尿病的存在与高刚性参数β值独立相关。在随访期间,有15例患者(21.4%)死亡,而16例(22.9%)发生了新的心血管事件。 Kaplan-Meier分析的结果表明,刚度参数β值最高的HD患者全因死亡的风险显着更高(p = 0.0106)。根据ROC曲线,可产生最大预测全因死亡率的敏感性和特异性的临界值为10.1,使用该临界值的敏感性和特异性分别为69.2%和70.2%。
结论:这项研究的结果表明,刚度参数β是慢性HD患者全因死亡率的预测指标。

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