河南省城区中老年人慢性肾脏病相关危险因素的研究

Investigation on associated risk factors of chronic kidney disease among population older than 40 years in urban communities of Henan province

目的揭示河南省城区中老年人慢性肾脏病（CKD）的流行病学现状及流行特征，从而加强对CKD的防治，减少和延缓终末期肾脏病的发生，同时也为国家公共卫生政策、医疗保险政策的制定提供可靠的依据。方法抽取河南省郑州市、焦作市、平顶山市城区40岁以上常住居民，对其进行问卷调查、体格检查和肾功能及血糖、血脂检测，并进行统计学分析和比较。结果①本研究共收集有效样本3981例，应答率95．7％，年龄40～89岁，男2178例，女1803例，男女比例1．21：1；吸烟、高血压、糖尿病、血脂异常、高尿酸血症、超体质量或肥胖、冠心病、脑卒中、个人用药史和肾脏病家族史的检出率分别为9．6％、15．0％、5．8％、38．1％、13．3％、22．2％、37．2％、18．3％、10．0％、1．5％。②该人群中白蛋白尿、血尿和肾小球滤过率（GFR）下降粗患病率分别为5．0％、6：3％和1．5％，男性白蛋白尿和血尿患病率低于女性，而GFR下降患病率高于女性（P〈0．01）；白蛋白尿和GFR下降患病率均随年龄的增加而升高（P〈0．01）。③该人群CKD的粗患病率为10．6％，标化患病率为10．5％；按照年龄分组后，CKD患病率随年龄增加而升高（P〈0．01）。④经logistic多因素回归分析，年龄、高血压、糖尿病、高尿酸血症与CKD独立相关。⑤该人群CKD知晓率9．5％，治疗率8．3％。结论河南省城区中老年人CKD具有较高的患病率；年龄、高血压、糖尿病、高尿酸血症是CKD的基础危险因子；河南省CKD防治形势严峻，CKD知晓率和治疗率均低于西方国家。

Objective To determine the epidemiology of ehronie kidney disease（CKD） among population older than 40 years in urban communities of Henan province. It will be helpful to health providers and medical professionals in controlling the pandemie of CKD effectively. And also important in evoking the establishing of effective prevention of CKD to control the pandemic of CKD. Methods All subjects received a questionnaire. Each participant underwent body mass,height, waist circumference, hip circumference and blood pressure measurements, using a calibrated scale. Indieators of kidney damage, blood sugar and blood cholesterol were examined in the laboratory. Data entry and management were performed by statistics. Results ① Eligible data of 3 981 subjects were enrolled in the study. Indicator of kidney disease was available for 95.7% of the participants examined. Age ranged from 40 to 90 years old and the sex ratio（male ： female） was 1.21 ： 1. The detection rates of smoking,hypertension, diabetes,dyslipidemia, hyperuricemia,hypergravitation/obesity, coronary heart disease, stroke, history of medications and family history of kidney disease were 9.6%,15.0% ,5.8%,38.1% ,13.3% ,22.2% ,37.2%,18.3% ,10.0% ,1.5% respectively. ②The crude prevalance of albuminuria,hematuria and reduced glomerular filtration rate（GFR） were 5.0 %, 6.3 % and 1.5 %. Women had higher prevalence of albuminuria and hematuria than men（ P 〈0.01）, but adverse in reduced GFR. Both prevalence of albuminuria and reduced GFR increased with age（ P 〈0.01）. ③The crude prevalence of CKD was 10.6%while the standardized rate was 10.5%,CKD also increased with age（ P 〈0.01）. ④With multiple factors logistic regression analysis,age,hypertension, diabetes and hyperuricemia independently correlated with CKD. ⑤The awareness rate of CKD was only 9.5 %,and the cure rate just 8.3%. Conclusion The prevalence of CKD is in a higher level among population older than 40 years in Henan province. Age,hypertension, diabetes and hyperuricemia are basic risk factors of CKD. The awareness and cure rate of CKD among adults in Henan province are far lower than those in Western developed countries.