Risks for mortality and renal replacement therapy in atherosclerotic renovascular disease compared with other causes of chronic kidney disease.

Autor: Ritchie J; Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK., Green D; Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK., Alderson HV; Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK., Chiu D; Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK., Sinha S; Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK., Kalra PA; Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK.
Jazyk: angličtina
Zdroj: Nephrology (Carlton, Vic.) [Nephrology (Carlton)] 2015 Oct; Vol. 20 (10), pp. 688-696.
DOI: 10.1111/nep.12501
Abstrakt: Aim: Patients with atherosclerotic renovascular disease (ARVD) have an increased risk for death and likelihood of initiating renal replacement therapy (RRT) compared with the general population. No data exist to describe prognosis in ARVD compared with other causes of chronic kidney disease (CKD). We compare patient outcomes between ARVD and other causes of CKD.
Methods: Patients were selected from two prospective observational cohort studies of outcome in ARVD and CKD. Multivariate Cox regression was used to compare risk for RRT and death (both prior to and following initiation of RRT) between patients with ARVD and other causes of CKD.
Results: Of 1472 patients (563 (38%) ARVD, 909 (62%) non-ARVD), 242 (16%) progressed to RRT and 640 (44%) died over a median follow-up period of 4.1 (2.4-5.6) years. Patients with ARVD had an increased risk for death (HR 1.5 (1.2-1.8), P < 0.001) but not for RRT (HR 1.0 (0.7-1.4), P = 0.9). The largest increase in risk for death was observed relative to renal limited diseases, e.g. pyelonephritis (HR 2.4 (1.3-4.5), P = 0.004) and interstitial/infiltrative disease (HR 2.2 (1.3-4.5), P = 0.02). Following initiation of RRT, patients with ARVD had a significantly increased risk for death compared with patients without ARVD (HR 3.3 (2.2-5.0), P < 0.001).
Conclusions: Patients with ARVD as a cause of CKD have an increased risk for death both prior to and following initiation of RRT. Further work should seek to identify modifiable risk factors relevant to prognosis.
(© 2015 Asian Pacific Society of Nephrology.)
Databáze: MEDLINE
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