80岁及以上老年住院患者肾功能及相关危险因素分析

Kidney function changes and the risk factors in hospitalized patients aged 80 years and over

目的了解≥80岁老年人肾功能的情况及相关危险因素。方法选择本院≥80岁老年住院患者1054例，通过测定血肌酐、血尿素、血尿酸、尿常规等，用Cockcroft-Gault公式估算肾小球滤过率（eGFR）值。结果本组肾功能下降的发生率为87．1％，eGFR30～59ml·min-1·1．73m。者占66．2％；肾功能下降Ⅱ组（eGFR15～29ml·min。·1．73m-2）患者性别之间比较，差异有统计学意义（P〈0．05）。老年人早期肾功能损害血肌酐检测不是理想的指标，尤其是消瘦的老年人。多因素Logistic回归分析显示，性别、高血压、冠心病、高尿酸血症是肾功能下降的危险因素（OR=1．937、1．602、1．842、7．020，均P〈0．05）。结论高龄老年人肾功能异常率高，影响其风险因素较多。

Objective To investigate the kidney function changes and the risk factors in elderly patients aged 80 years and over. Methods A total of 1054 hospitalized patients aged ≥80 years in our hospital were selected. Serum levels of creatinine, urea, uric acid and urinate were tested. Cockcroft-Gault equation was used to estimate glomerular filtrate rate （GFR）. Results The renal function in 87. 1% of the patients was reduced. The percentage of patients with 30≤eGFR %60 ml · min-1· 1.73 m-2 was 66.2%. The percentage of patients with 15≤eGFR 〈30 ml ·min-1 ·1.73·m-2 had a gender difference （ P〈 0.05）. Serum creatinine level was not an ideal indicator for early renal dysfunction in the elderly, especially in emaciated elderly people. Multivariate logistic regression analysis showed that gender, hypertension, coronary heart disease and hyperuricemia were independent risk factors for the decline of renal function （OR= 1. 937, 1. 602, 1. 842, 7.020, respectively,all P〈0.05）. Conclusions The rate of renal dysfunction is high in very old people. Many risk factors affect renal dysfunction.