Читать книгу Recent Advances in Dialysis Therapy in Japan - Группа авторов - Страница 42

Patients with LVH had worse dialysis-free survival than those without LVH (p < 0.01) in CKD 1–3 patients (Fig. 3a). Patients with low Hb (Hb <11.9 g/dL) had worse dialysis-free survival than those with high Hb (Hb >12.0 g/dL) (p < 0.0001) (Fig. 3b). In stepwise logistic regression analysis, levels of SBP, LAV, and serum albumin (Alb) were independent risk factors for duration before initiation of HD in CKD (stages 4–5). LVMI increased with decreasing renal function (Fig. 4b), and eccentric LV remodeling was increased in CKD (stages 1–5) patients (Fig. 4a). In univariate analysis, SBP, urine protein/urine creatinine ratio, serum creatinine, phosphorus, and erythropoietin dose were directly correlated with LVMI (p < 0.01). The levels of Hb, Alb, and iron were inversely correlated with LVMI (p < 0.0001). In stepwise linear regression analysis, SBP and Hb were identified as independent risk factors for LVMI. The prevalence of LVH increased with advanced CKD (p < 0.001). Comparing mean SBP and Hb with and without LVH in each CKD stage, we found that SBP was significantly higher in patients with LVH in stages 2 and 5, and Hb was significantly lower in patients with LVH in stages 4 and 5 than in those in the other stages.

Fig. 1. a Serial changes in left ventricular mass index (LVMI) and residual glomerular filtration rate (rGFR) in peritoneal dialysis (PD) patients. b Serial changes in LVMI and rGFR in hemodialysis (HD) patients. * p < 0.01; ^#p < 0.05.