論文

査読有り 国際誌
2019年3月

Higher pulse pressure predicts initiation of dialysis in Japanese patients with diabetes

DIABETES-METABOLISM RESEARCH AND REVIEWS
  • Taeko Osawa
  • ,
  • Kazuya Fujihara
  • ,
  • Mayuko Harada
  • ,
  • Masahiko Yamamoto
  • ,
  • Masahiro Ishizawa
  • ,
  • Hiroshi Suzuki
  • ,
  • Hajime Ishiguro
  • ,
  • Yasuhiro Matsubayashi
  • ,
  • Hiroyasu Seida
  • ,
  • Nauta Yamanaka
  • ,
  • Shiro Tanaka
  • ,
  • Hitoshi Shimano
  • ,
  • Satoru Kodama
  • ,
  • Hirohito Sone

35
3
開始ページ
e3120
終了ページ
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1002/dmrr.3120
出版者・発行元
WILEY

Aims To determine incidence and predictors of starting dialysis in patients with diabetes emphasizing blood pressure variables. Methods A nationwide database with claim data on 18 935 people (15 789 men and 3146 women) with diabetes mellitus aged 19 to 72 years in Japan was used to elucidate predictors for starting dialysis. Initiation of dialysis was determined from claims using ICD-10 codes and medical procedures. Using multivariate Cox modelling, interactions between glycaemic and blood pressure values were determined. Results During a median follow-up of 5.3 years, incidence of dialysis was 0.81 per 1000 person-years. Multivariate analysis of a model involving systolic and diastolic blood pressure (SBP and DBP) simultaneously as covariates showed that hazard ratios (HRs) for starting dialysis for each 1-SD elevation in SBP and DBP were 2.05 (95% confidence interval 1.58-2.64) and 0.66 (0.50-0.88), respectively, implying that pulse pressure (PP) was a promising predictor. For confirmation, a model involving SBP and PP simultaneously as covariates demonstrated that HRs for each 1-SD elevation in SBP and PP were 1.09 (0.81-1.48) and 1.54 (1.14-2.08), respectively, with PP the more potent predictor. Compared with HbA(1c) <8% and PP <60 mmHg, the HR for those with HbA(1c) >= 8% and PP >= 60 mmHg was 6.32 (3.42-11.7). Conclusions In our historical cohort analysis, SBP and PP were independent predictors for starting dialysis. PP was the more potent, suggesting the contribution of increased arterial stiffness to the incidence of dialysis. Future studies are needed to conclude the independent influence of PP and HbA(1c) on dialysis considering other risk factors.

Web of Science ® 被引用回数 : 1

リンク情報
DOI
https://doi.org/10.1002/dmrr.3120
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30578707
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000460336400002&DestApp=WOS_CPL

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