上海市浦东社区中老年人群慢性肾脏病的流行病学调查

Prevalence and risk factors of chronic kidney disease in middle-aged and older adults in Shanghai Pudong New District WANG Yi ＊ , QU Xiao-lu, WANG Xin-hua, ZHU Ai-guo, YU Chert, ZHANG Xin- tiart, ZHANG Rui-qirtg, XIONG Chortg-xiang, LIU Fertg, WANG Jurt, ZHANG Yirtg-yirtg, YAN Hai-dong.Pudong New District

目的了解上海市浦东社区中老年人群慢性肾脏病（CKD）的患病率及危险因素。方法2006年7月至2010年6月在上海浦东新区随机抽取／〉45岁居民2000名，进行问卷调查和体格检查，测尿白蛋白／肌酐、尿常规、血清肌酐、葡萄糖和血脂，并计算估计的肾小球滤过率（eGFR）。结果1905名（82．1％）居民入选，白蛋白尿检出234例，标化患病率为12．0％（95％CI：0．105～0．135）；eGFR〈60ml·min～^-1．73m^-2者36例，标化患病率为1．9％（95％CI：0．172—0．213）；按慢性肾脏病：改善全球预后（KDIGO）诊断标准，CKD患者共240例，标化患病率为12．6％（95％C1：0．112～0．142）。多元logistic回归分析显示，高血压（OR=2．272）、高血糖（OR=1．233）、年龄（OR：1．043）、高胆固醇（OR=1．187）、高尿酸（OR=1．003）是中老年人群CKD的独立危险因素。结论上海浦东社区中老年人群CKD的患病率较高，应积极开展CKD的早期筛查，干预高危人群以延缓CKD的进展，避免终末期肾病的发生。

Objective To investigate the prevalence and risk factors of chronic kidney disease （CKD） in middle-aged and older adult population in Shanghai Pudong New District. Methods Two thousand residents aged 45 years and above were randomly selected for questionnaire survey and health check-up in Shanghai Pudong New District from July 2006 to October 2010. The laboratory examinations were also performed including the urine routine, urinary protein to creatinine ratio, serum ereatinine, blood glucose and lipids. The glomerular filtration rate （eGFR） was estimated by simplified Chinese MDRD （modification of Diet in Renal Disease） equation. SPSS 13.0 statistical software was used for statistical analysis. Results Among 1905 residents who completed survey and examinations, the adjusted prevalence of albuminuria was 12.0% （95% CI：O. 105 -0. 135） and of eGFR less than 60 ml· min^-1 · 1.73 m^-2 was 1.9% （95% CI： O. 172 - O. 213 ）. The prevalence of CKD was 12. 6% （ 95% CI： 0. 112 - 0. 142）. Logistic regression analysis revealed that age （ OR = 1. 043 ）, hypertension （ OR = 2. 272 ）, diabetes mellitus （ OR = 1. 233） and hyperuricemia （ OR -- 1. 003 ） were independently associated with CKD. Conclusions The prevalence of CKD in adult residents （/〉45 years） from Shanghai Pudong New District is high. It is necessary to carry out early screening and to intervene risk factors of CKD in middle-aged and older residents.