...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>American Journal of Kidney Diseases: The official journal of the National Kidney Foundation >Effect of hemoglobin target on progression of kidney disease: A secondary analysis of the CHOIR (Correction of Hemoglobin and Outcomes in Renal Insufficiency) trial
【24h】

Effect of hemoglobin target on progression of kidney disease: A secondary analysis of the CHOIR (Correction of Hemoglobin and Outcomes in Renal Insufficiency) trial

机译：血红蛋白靶标对肾脏疾病进展的影响：CHOIR（肾功能不全患者的血红蛋白校正和预后）试验的二级分析

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: Conflicting relationships have been described between anemia correction using erythropoiesis-stimulating agents and progression of chronic kidney disease (CKD). This study was undertaken to examine the impact of target hemoglobin level on progression of kidney disease in the CHOIR (Correction of Hemoglobin and Outcomes in Renal Insufficiency) trial. Study Design: Secondary analysis of a randomized controlled trial. Setting & Participants: 1,432 participants with CKD and anemia. Intervention: Participants were randomly assigned to target hemoglobin levels of 13.5 versus 11.3 g/dL with the use of epoetin alfa. Outcomes & Measurements: Cox regression was used to estimate HRs for progression of CKD (a composite of doubling of creatinine level, initiation of renal replacement therapy, or death). Interactions between hemoglobin target and select baseline variables (estimated glomerular filtration rate, proteinuria, diabetes, heart failure, and smoking history) also were examined. Results: Participants randomly assigned to higher hemoglobin targets experienced shorter time to progression of kidney disease in both univariate (HR, 1.25; 95% CI, 1.03-1.52; P = 0.02) and multivariable models (HR, 1.22; 95% CI, 1.00-1.48; P = 0.05). These differences were attributable to higher rates of renal replacement therapy and death for participants in the high hemoglobin arm. Hemoglobin target did not interact with estimated glomerular filtration rate, proteinuria, diabetes, or heart failure (P > 0.05 for all). In the multivariable model, hemoglobin target interacted with tobacco use (P = 0.04) such that the higher target had a greater risk of CKD progression for participants who currently smoked (HR, 2.50; 95% CI, 1.23-5.09; P = 0.01), which was not present for those who did not currently smoke (HR, 1.15; 95% CI, 0.93-1.41; P = 0.2). Limitations: A post hoc analysis; thus, cause and effect cannot be determined. Conclusions: These results suggest that a high hemoglobin target is associated with a greater risk of progression of CKD. This risk may be augmented by concurrent smoking. Further defining the mechanism of injury may provide insight into methods to optimize outcomes in anemia management.
机译：背景：已经描述了使用促红细胞生成剂纠正贫血与慢性肾脏病（CKD）进展之间相互矛盾的关系。这项研究的目的是在CHOIR（肾功能不全患者的血红蛋白校正和预后）校正中检查目标血红蛋白水平对肾脏疾病进展的影响。研究设计：一项随机对照试验的二级分析。参与者：1,432名患有CKD和贫血的参与者。干预：参与者被随机分配到目标血红蛋白水平为13.5 vs 11.3 g / dL的使用epoetin alfa。结果与测量：使用Cox回归来估算CKD进展（肌酐水平加倍，开始肾脏替代治疗或死亡的复合物）的HR。还检查了血红蛋白靶标和所选基线变量（估计的肾小球滤过率，蛋白尿，糖尿病，心力衰竭和吸烟史）之间的相互作用。结果：在单变量（HR，1.25; 95％CI，1.03-1.52; P = 0.02）和多变量模型（HR，1.22; 95％CI，1.00）中，随机分配给较高血红蛋白靶标的参与者经历肾脏疾病进展的时间较短-1.48; P = 0.05）。这些差异归因于高血红蛋白组参与者的肾脏替代治疗率更高和死亡。血红蛋白靶标与估计的肾小球滤过率，蛋白尿，糖尿病或心力衰竭没有相互作用（所有P> 0.05）。在多变量模型中，血红蛋白靶标与烟草使用有相互作用（P = 0.04），因此较高的靶标对当前吸烟的参与者有更大的CKD进展风险（HR，2.50; 95％CI，1.23-5.09; P = 0.01） ，对于那些目前不吸烟的人来说不存在（HR，1.15; 95％CI，0.93-1.41; P = 0.2）。局限性：事后分析;因此，无法确定因果关系。结论：这些结果表明，高血红蛋白靶标与CKD进展的更大风险相关。同时吸烟可能会增加这种风险。进一步定义损伤的机制可以提供对优化贫血管理结果的方法的了解。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号