Ren Fail：缺铁是血液透析患者5年全因死亡率的重要预测因子

2021-08-17 MedSci原创 MedSci原创发表于上海

缺铁（低TSAT、铁或铁蛋白）是HD患者5年全因死亡率的重要预测因子。

缺铁在晚期肾病患者中很常见，尤其是那些需要血液透析 (HD) 的患者。事实上，铁对血管平滑肌细胞转化影响的研究表明它与内壁钙化有关，因此铁浓度可能与血管钙化的严重程度和 HD 患者的死亡率有关。而且，高冠状动脉钙化评分(CACS)可能也与接受血液透析(HD)的患者的高死亡率有关。

近期，《Renal Failure》发表了一篇临床研究，旨在调查HD患者中铁、CACS和死亡率之间的关系，结果发现较低的TSAT是CACS≥400的独立预测因子，缺铁（低TSAT、铁或铁蛋白）是HD患者5年全因死亡率的重要预测因子。

该研究纳入了173名持续接受HD的患者，并在基线时获得了两组患者的实验室数据和Agatston's CACS：CACS≥400的患者(n=109)和CACS＜400的患者(n=64)，后面进行了CACS≥400时死亡率的逻辑回归分析和Cox比例风险分析。

参与者的中位（四分位距）年龄和透析持续时间分别为67(60-75)岁和73(37-138)个月。CACS≥400的参与者的血清铁(Fe)和转铁蛋白饱和度(TSAT)水平显着低于CACS＜400的参与者，但各组之间的血清铁蛋白浓度没有差异。TSAT≥21%与CACS≥400显着相关（RR=0.46，p＜0.05）。

TSAT≥17%、Fe≥63µg/dL和铁蛋白≥200ng/mL是HD患者5年全因死亡率的重要预测因子，独立于全因死亡率的常规风险因素(p＜0.05)。

转铁蛋白饱和度≥17%和＜17%的参与者的Kaplan-Meier 5年累积生存曲线

TSAT：转铁蛋白饱和度

血清铁≥63和＜63µg/dL的参与者的Kaplan-Meier5年累积生存曲线

Fe：血清铁

所有参与者的血清CRP、TSAT、Fe和铁蛋白的散点图矩阵

该研究确定了HD患者中铁、CACS和死亡率之间的关联，发现较低的TSAT是CACS≥400的独立预测因子，缺铁（低TSAT、铁或铁蛋白）是HD患者5年全因死亡率的重要预测因子。

原文出处：Mizuiri S, Nishizawa Y, Doi T, Yamashita K, Shigemoto K, Usui K, Arita M, Naito T, Doi S, Masaki T. Iron, coronary artery calcification, and mortality in patients undergoing hemodialysis. Ren Fail. 2021 Dec;43(1):371-380. doi: 10.1080/0886022X.2021.1880937. PMID: 33596750; PMCID: PMC7894440.

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2021-08-19 lvliquan

#全因死亡率#

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2021-08-19 habb

#血液透析#

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2021-08-19 宋威

#预测因子#

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2021-08-19 luckyshitiancai_42705684

#缺铁#

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2021-08-19 ewsr6

#透析患者#

73 0
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2021-08-18 unlobotomy

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