初诊慢性肾脏病3~5期非透析患者贫血状况调查及影响因素分析

Investigation on prevalence of anemia and its influencing factors in newly non-dialysis patients with stage 3-5 chronic kidney disease

目的:了解初诊慢性肾脏病(CKD)3~5期非透析患者的贫血状况,分析贫血的影响因素。方法:选取2016年2月至2021年6月在乐山市人民医院肾病内科住院治疗的初诊CKD3~5期非透析患者,收集其贫血治疗前的首次实验室检查指标,调查初诊CKD3~5期非透析患者的贫血状况。根据Hb水平将入选患者分为贫血组和无贫血组,比较两组相关实验室检查指标的差异,采用多因素Logistic回归分析贫血的影响因素。结果:(1)525例初诊CKD3~5期非透析患者的贫血总患病率为87.8%,轻、中、重度贫血在贫血患者中的比例依次为48.2%、44.7%、7.1%;(2)各期贫血患病率依次为61.2%、90.4%、98.9%,贫血形态主要为正细胞正色素贫血。多因素Logistic回归显示女性性别、低白蛋白血症及CKD分期恶化是贫血的独立危险因素,高甘油三酯血症则是贫血的保护因素。结论:初诊CKD3~5期非透析患者普遍存在贫血,其患病率和CKD分期密切相关,其影响因素可能取决于CKD分期恶化、低白蛋白血症、女性性别和高甘油三酯血症。

Objective:To investigate the anemia status and its influencing factors in newly diagnosed non-dialysis patients with stage 3-5 chronic kidney disease(CKD).Methods:The newly diagnosed non-dialysis patients with stage 3-5 CKD who were hospitalized in the department of nephrology,People's Hospital of Leshan from February 2016 to June 2021 were enrolled.The indexes of first laboratory examination before anemia treatment were collected to investigate the anemia status in newly diagnosed non-dialysis patients with stage 3-5 CKD.The enrolled patients were then divided into anemia group and non-anemia group based on Hemoglobin(Hb)level.The differences of related laboratory examination indexes between the two groups were compared,and the influencing factors of anemia were analyzed by multivariate logistic regression analysis.Results:(1)The total prevalence of anemia in 525 stage 3-5 CKD patients was 87.8%,and the proportions of mild,moderate and severe anemia were 48.2%,44.7%and 7.1%,respectively.(2)The prevalence of anemia in each stage was 61.2%,90.4%and 98.9%,respectively.The anemia form was mainly normocytic-normochromic anemia.Multivariate logistic regression analysis showed that female sex,hypoalbuminemia,and CKD stage deterioration were independent risk factors for anemia,while hypertriglyceridemia was a protective factor for anemia.Conclusion:Anemia is common in newly diagnosed nondialysis patients with stage 3-5 CKD.The prevalence of anemia are closely related to the stage of CKD,and the deterioration of CKD stage,hypoalbuminemia,female sex and hypertriglyceridemia are influencing factors.