内蒙古呼伦贝尔地区成人慢性肾脏病流行病学调查

Epidemiology investigation of adult chronic kidney disease in the Hulunbeir Prefecture,Inner Mongolia autonomous region

目的 探讨我国内蒙古自治区呼伦贝尔少数民族聚居区成年人群中慢性肾脏病（CKD）患病率及其危险因素.方法 对该地区20岁以上常住居民进行CKD抽样调查,被调查者均检测了尿白蛋白/肌酐比率、血尿（离心后尿沉渣显微镜检查）及估计肾小球滤过率（eGFR,检验血清肌酐后用国人校正的简化MDRD公式计算）;并同时调查了CKD的相关危险因素.结果 符合入选条件的被调查者共4522例,白蛋白尿阳性率为7.11%;血尿阳性率为2.64%;eGFR低于60 ml·min^-1·（1.73 m^2）^-1者为2.75%;去除白蛋白尿、血尿及eGFR下降共同存在造成的重复,该地区CKD患病率为12.95%.高血压患病率38.90%,糖代谢异常6.61%,脂代谢异常34.60%,腰围增大24.79%,代谢综合征15.02%.多因素Logistic回归分析及分层分析显示,年龄增加、腰围增大、收缩压升高、空腹血糖升高、血清三酰甘油增高及患代谢综合征与白蛋白尿发生相关;年龄增加、收缩压升高及空腹血糖升高与肾功能下降相关;年龄增加与血尿发生相关.结论 内蒙古自治区呼伦贝尔地区CKD患病率为12.95%.相关危险因素包括年龄增加、腰围增大、高血压、血糖或血脂异常、及代谢综合征.

Objective To investigate the prevalence and risk factors of chronic kidney disease （CKD） in the general adult population in the Hulunbeir Prefecture, Inner Mongolia Autonomous Region where many minorities of north China live. Methods Sampling surveywas performed in the residents aged 20 years and older in the Hulunbeir Prefecture. All the investigated subjects were tested for urinary albumin to creatinine ratio （ACR）; hematuria by microscopy of urinary sediment; and GFR estimated by modified MDRD equation for Chinese adults （eGFR）. The related risk factors of CKD were also investigated. Results A total of 4522 subjects were enrolled in the study. The prevalence of albuminuria was 7.11%, hematuria was 2.64% and reduced eGFR [60 ml·min^-1·（1.73 m^2）^-1] was 2.75%. The prevalence of hypertension was 38.90%; hyperglycemia 6.61%; hyperlipidemia 2.72%; increased waist 24.79% and metabolic syndrome 15.02%. After the subjects with combined microalbuminuria, hematuria and reduced eGFR were excluded, the prevalence of CKD was 12.95%. Logistic regression analysis and stratified analysis showed increased age, increased waist, elevated systolic pressure, hyperglycemia,hypertriglyceridemia and metabolic syndrome were independently associated with albuminuria;increased age, elevated systolic pressure and hyperglycemia were independently associated with reduced eGFR; increased age was independently associated with hematuria. Conclusions The prevalence of adult CKD is 12.95% in the Hulunbeir Prefecture, Inner Mongolia Autonomous Region. Independent risk factors of CKD include increased age, increased waist, hypertension,abnormal blood glucose or lipid, and metabolic syndrome.