成纤维细胞生长因子 21 可预测维持性血液透析患者动静脉瘘功能性通畅损失和死亡率。

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-01-10 DOI:10.1080/0886022X.2024.2302407
Xinhui Hu, Hong Ding, Qing Wei, Ruoxin Chen, Weiting Zhao, Liqiong Jiang, Jing Wang, Haifei Liu, Jingyuan Cao, Hong Liu, Bin Wang
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引用次数: 0

摘要

背景:动静脉瘘(AVF)功能障碍是接受维持性血液透析(MHD)患者的常见并发症。血清成纤维细胞生长因子 21 (FGF21) 水平升高与动脉粥样硬化和心血管死亡率有关。然而,其与血管通路预后的关系仍然难以捉摸。本研究评估了接受 MHD 的患者血清 FGF21 水平与 AVF 功能障碍和全因死亡率的关系:我们纳入了 2018 年 1 月至 2019 年 12 月使用 AVF 接受 MHD 的患者。使用酶联免疫吸附试验检测 FGF21 浓度。对患者进行随访,记录两种临床结果,即 AVF 功能性通畅损失和全因死亡率。随访期于2022年4月30日结束:147名患者的平均年龄为(58.49 ± 14.41)岁,血清中位 FGF21 水平为 150.15 (70.57-318.01) pg/mL。在中位 40.83 个月的随访期间,血清 FGF21 水平是 AVF 功能性通畅损失的独立危险因素(每增加 1 pg/mL,HR 1.002 [95% CI: 1.001-1.003, p = 0.003])。血清中 FGF21 水平较高的患者更有可能全因死亡(每增加 1 pg/mL,HR 1.002 [95% CI:1.000-1.003,p = 0.014])。FGF21预测MHD患者动静脉瘘功能性通畅损失和全因死亡率的最佳临界值分别为149.98 pg/mL和146.43 pg/mL,AUC分别为0.701(95% CI:0.606-0.796,P = 0.002):血清FGF21水平是MHD患者动静脉瘘功能性通畅损失和全因死亡率的独立危险因素和预测因子。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fibroblast growth factor 21 predicts arteriovenous fistula functional patency loss and mortality in patients undergoing maintenance hemodialysis.

Background: Arteriovenous fistula (AVF) dysfunction is a common complication in patients undergoing maintenance hemodialysis (MHD). Elevated serum levels of fibroblast growth factor 21 (FGF21) are associated with atherosclerosis and cardiovascular mortality. However, its association with vascular access outcomes remains elusive. The present study evaluated the relationship of serum FGF21 levels with AVF dysfunction and all-cause mortality in patients undergoing MHD.

Methods: We included patients undergoing MHD using AVF from January 2018 to December 2019. FGF21 concentration was detected using enzyme-linked immunosorbent assay. Patients were followed up to record two clinical outcomes, AVF functional patency loss and all-cause mortality. The follow-up period ended on April 30, 2022.

Results: Among 147 patients, the mean age was 58.49 ± 14.41 years, and the median serum level of FGF21 was 150.15 (70.57-318.01) pg/mL. During the median follow-up period of 40.83 months, the serum level of FGF21 was an independent risk factor for AVF functional patency loss (per 1 pg/mL increase, HR 1.002 [95% CI: 1.001-1.003, p = 0.003]). Patients with higher serum levels of FGF21 were more likely to suffer from all-cause mortality (per 1 pg/mL increase, HR 1.002 [95% CI: 1.000-1.003, p = 0.014]). The optimal cutoffs for FGF21 to predict AVF functional patency loss and all-cause mortality in patients undergoing MHD were 149.98 pg/mL and 146.43 pg/mL, with AUCs of 0.701 (95% CI: 0.606-0.796, p < 0.001) and 0.677 (95% CI: 0.595-0.752, p = 0.002), respectively.

Conclusions: Serum FGF21 levels were an independent risk factor and predictor for AVF functional patency loss and all-cause mortality in patients undergoing MHD.

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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
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