上海市浦东新区成人慢性肾脏病流行病学调查

Epidemiology investigation of chronic kidney disease in adults of Shanghai Pudong New Area

目的了解上海市浦东新区社区居民慢性肾脏病（CKD）的患病率及主要危险因素。方法2008年4月至7月，在上海市浦东新区随机多阶段抽取20～80岁的社区居民5584人进行问卷调查，进行横断面研究。收集一般情况和生活方式等信息。收集空腹血和晨尿，检测Scr、尿肌酐（Ucr）及尿微量白蛋白等指标，计算尿白蛋白和肌酐比值（ACR），并依Scr水平计算肾小球滤过率（eGFR）。结果上海浦东新区成年居民白蛋白尿、肾功能下降和CKD的标化患病率分别为9．9％（男性8．0％、女性12．4％）、1．1％（男性1．3％、女性0．9％）和11．0％（男性8．8％，女性12．7％）。女性CKD患病率高于男性，并随年龄增长而上升。调整年龄和性别后，城郊患病率间差异无统计学意义。多因素Logistic回归分析显示，高龄、女性、高血压、高空腹血糖、高三酰甘油血症、超重或肥胖是白蛋白尿、CKD的独立危险因素。结论上海市浦东新区成人CKD的患病率接近甚至高于国内外既往研究结果。肾脏损伤已成为危及该地区居民健康的重大公共卫生问题，需重视CKD的早期发现和干预，避免终末期肾脏病（ESRD）和相关并发症的发生。

Objective To investigate the prevalence and risk factors of chronic kidney disease （CKD） in adult residents of Shanghai Pudong New Area. Methods A total of 5584 residents aged 20-80 years old were randomly selected from Shanghai Pudong New Area through multistage sampling and interview between April and July 2008. Fasting blood samples and morning urine samples were collected to detect Scr and urinary albumin and creatinine. Urine albumin to creatinine ratio （ACR） and glomerular filtration rate （GFR） was calculated to estimate the renal function. Logistic regression model was used to examine the associations of demographic and lifestyle factors with indicators of kidney damage. Results The age-standardized prevalence ofalbuminuria, reduced renal function and CKD was 9.9% （male 8.0%, female 12.4%）, 1.1% （male 1.3%, female 0.9%） and ll.0%（male 8.8%, female 12.7%）, respectively. The prevalence of CKD was higher in female and increased with age. No significant difference in the prevalence was observed between urban and rural areas. Elder, female, high blood pressure, high fasting glucose, dyslipidemia and obesity were associated with CKD independently. Conclusions The prevalence of CKD in Shanghai Pudong New Area is comparable to that previously reported in China or other developed countries, and even higher. CKD is going to be a pubhc health problem and warrants the community-integrated control strategy to prevent the incidence of end-stage renal disease （ESRD） and related complications.