慢性肾衰竭2313例病因及首发表现临床分析

Clinical Analysis of 2313 Patients with Chronic Renal Failure(CRF) and Their Initial Symptoms

目的探讨慢性肾衰竭(chronic renal failure,CRF)的病因及首发表现,为CRF的诊断提供依据。方法对我院20年收治的2313例CRF原发病、首发表现及首诊科室按每5年一个时间段进行统计,并根据发生率高低排列CRF高危人群及首发表现金字塔。结果 20年间CRF原发病仍以慢性肾炎所占比例最高,达55.0%;其次高血压、糖尿病患者已成为CRF主要高危人群,后一个时间段(5年)与前一个时间段(5年)比较差异均有统计学意义(P<0.01)。CRF首发表现为全身多器官表现,有51.7%的患者首诊未收治到肾脏专科。水肿、尿检异常793例,占34.3%,位于金字塔尖。结论 CRF原发病以慢性肾炎、高血压、糖尿病为主,提高临床医师及公众对该病的认识和知晓率是减少发病并延缓病情进展的关键。

Objective To investigate the cause and initial symptoms of chronic renal failure（CRF） in order to provide basis for CRF diagnosis. Methods Retrospective analysis of 2313 CRF inpatients were conducted in regards to primary disease, initial symptoms and first visit to hospital during the past 20 years, every 5 years as a time phrase. A pyramid was established according to incidence rate to determine high risk population and initial symptoms. Results The first primary disease of CRF was Glomerulonephritis（55.0% ） in the past 20 years. Hypertension and diabetes patients with accounted for main high risk population of CRF. Initial symptoms of CRF were related to multiple-organs, 51.7% of the patients were not admitted for first visit for nephrology. Edema and abnormal urine test accounted for 34.3% on the top of pyramid. Conclusion CRF primary disease is mainly manifested by glomerulonephritis, hypertension and diabetes. Awareness of the disease by clinicians and the public will reduce CRF incidence rate and delay progression of the disease.