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总胆红素与持续不卧床腹膜透析患者全因死亡及心血管疾病死亡的相关性研究.docx

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总胆红素与持续不卧床腹膜透析患者全因死亡及心血管疾病死亡的相关性研究 Title:TheCorrelationbetweenTotalBilirubinandAll-causeMortalityandCardiovascularDiseaseMortalityinPatientsUndergoingContinuousAmbulatoryPeritonealDialysis Abstract: Introduction:Continuousambulatoryperitonealdialysis(CAPD)isawidelyusedrenalreplacementtherapyforpatientswithend-stagerenaldisease(ESRD).However,long-termcomplicationssuchascardiovasculardisease(CVD)andall-causemortalityremainmajorconcernsinthesepatients.Totalbilirubin(TB)isapotentialmarkerthathasbeenassociatedwithbothCVDandmortalityinvariouspopulations.ThisstudyaimstoinvestigatethecorrelationbetweenTBlevelsandall-causemortalityaswellasCVDmortalityinpatientsundergoingCAPD. Methodology:AretrospectivecohortstudywasconductedonCAPDpatientswhowerefollowedupbetween20XXand20XX.Baselinecharacteristics,includingage,gender,comorbidities,dialysisduration,andlaboratoryparameters,wererecorded.TBlevelsweremeasuredatbaseline,andpatientswerecategorizedintoquartilesbasedonTBlevels.Theprimaryoutcomeswereall-causemortalityandCVDmortality.CoxproportionalhazardsregressionmodelswereusedtoassesstheassociationbetweenTBlevelsandtheseoutcomesafteradjustingforpotentialconfounders. Results:AtotalofXXXCAPDpatientswereincludedintheanalysis,withamedianfollow-upofXXmonths.ThemeanageofthepatientswasXXyears,andXX%weremale.Duringthefollow-upperiod,XX%ofpatientsdied,andXX%diedfromCVD-relatedcauses.Afteradjustingforconfounders,higherTBlevelsweresignificantlyassociatedwithalowerriskofall-causemortality(HR:XX;95%CI:XX-XX;p<0.001)andCVDmortality(HR:XX;95%CI:XX-XX;p=0.XXX).Theassociationremainedsignificantevenafterfurtheradjustmentsforotherrelevantfactors,includingage,comorbidities,anddialysisduration. Discussion:ThefindingsofthisstudysuggestastronginversecorrelationbetweenTBlevelsandbothall-causemortalityandCVDmortalityinpatientsundergoingCAPD.Thisassociationremainedsignificantaftercontrollingforpotentialconfounders,indicatingthatTBmayserveasaprognosticmarkerfortheseoutcomesinthispopulation.Theunderlyingmechani