Restrictive or Liberal Blood Transfusion in Patients with Myocardial Infarction and CKD.

IF 10.3 1区医学 Q1 UROLOGY & NEPHROLOGY

Journal of The American Society of Nephrology Pub Date : 2025-01-09 DOI:10.1681/ASN.0000000595

Jordan B Strom, Brandon M Herbert, Marnie Bertolet, Maria M Brooks, Shahbaz A Malik, Gilles Lemesle, Mina Madan, Philippe Gabriel Steg, Paul C Hebert, Jay H Traverse, Harvey D White, Caroline Alsweiler, Rajesh Gupta, Luiz Eduardo F Ritt, Mark A Menegus, John H Alexander, Renato D Lopes, Bernard R Chaitman, Jeffrey L Carson

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心肌梗死和CKD患者的限制性或自由输血。

背景：慢性肾脏疾病（CKD）与心肌梗死和贫血的高风险相关。在发生心肌梗死的贫血和CKD患者中，自由红细胞输血阈值策略（血红蛋白临界值[Hgb] < 10 g/dL）是否优于限制性输血阈值策略（Hgb 7-8 g/dL）仍不确定。方法：在参加心肌缺血与输血（MINT）试验的3,504例肌酐未缺失的患者中，我们比较了无CKD （N = 1279）、eGFR 30-60 mL/min/1.73 m2的CKD （N = 999）、eGFR < 30 mL/min/1.73 m2的CKD （N = 802）和需要透析的CKD （N = 415）患者的基线特征和30天和6个月的结局。结果：CKD分期和指定输注策略之间没有统计学上显著的相互作用。在eGFR < 30 mL/min/1.73 m2的非透析依赖患者中，限制性输血策略与自由输血策略相比，30天死亡或复发性心肌梗死的风险更高（风险差[RD]， 5.8%, 95% CI 0.4%至11.2%）。在eGFR为30-60 mL/min/1.73 m2的患者中，与自由输血策略相比，限制性策略与30天死亡或复发性心肌梗死的风险相似（RD, 3.7%, 95% CI -0.9%至8.2%）。在需要透析的CKD患者中，与自由输血策略相比，限制性策略与30天死亡或复发性心肌梗死的风险相似（RD, -2.6%, 95% CI -10.0%至4.8%）。结论：在MINT亚组分析中纳入的CKD患者中，自由输血策略并不比限制性输血策略更差，并且在未接受透析的亚组中危害更小。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of The American Society of Nephrology 医学-泌尿学与肾脏学

CiteScore

22.40

自引率

2.90%

发文量

492

审稿时长

3-8 weeks

期刊介绍： The Journal of the American Society of Nephrology (JASN) stands as the preeminent kidney journal globally, offering an exceptional synthesis of cutting-edge basic research, clinical epidemiology, meta-analysis, and relevant editorial content. Representing a comprehensive resource, JASN encompasses clinical research, editorials distilling key findings, perspectives, and timely reviews. Editorials are skillfully crafted to elucidate the essential insights of the parent article, while JASN actively encourages the submission of Letters to the Editor discussing recently published articles. The reviews featured in JASN are consistently erudite and comprehensive, providing thorough coverage of respective fields. Since its inception in July 1990, JASN has been a monthly publication. JASN publishes original research reports and editorial content across a spectrum of basic and clinical science relevant to the broad discipline of nephrology. Topics covered include renal cell biology, developmental biology of the kidney, genetics of kidney disease, cell and transport physiology, hemodynamics and vascular regulation, mechanisms of blood pressure regulation, renal immunology, kidney pathology, pathophysiology of kidney diseases, nephrolithiasis, clinical nephrology (including dialysis and transplantation), and hypertension. Furthermore, articles addressing healthcare policy and care delivery issues relevant to nephrology are warmly welcomed.