甘肃省终末期肾病患者的临床特征和治疗现状

Epidemiological study of the end stage renal disease patients in Gansu province

目的 初步分析甘肃省终末期肾病（ESRD）患者的临床特征和治疗现状.方法 以血液透析及腹膜透析登记网络系统为基础对兰州市八家三级医院及省内其他十三个地州医院2012至2013年内的门诊及住院ESRD患者进行回顾性分析.结果 （1）ESRD时点患病率为169.6/100万人口,平均年龄为（47.46±15.57）岁,30～ 59岁人群占70.0％,男女性别比为1：1.15,文化程度低者、体力劳动者ESRD构成比高.（2）原发疾病以慢性肾小球肾炎最多,占43.0％,其次是糖尿病肾病占31.0％,高血压肾病占11.0％,过敏性疾病占6.9％.（3）ESRD的治疗现状：血液透析占51.2％,腹膜透析占4.4％,肾移植占1.1％,未进行肾脏替代治疗占32.2％,死亡占11.1％.（4）ESRD患者未透析治疗的原因：经济困难占61.0％,血液透析条件缺乏占24.0％,放弃治疗占3.1％,家庭因素占2.3％,宗教原因占1.8％,其他占7.8％.结论 甘肃省ESRD时点患病率为169.6/100万人口,30～ 59岁为主要人群;ESRD主要病因为慢性肾小球肾炎、糖尿病肾病和高血压肾病;32.2％ESRD患者未行肾脏替代治疗,原因主要是患者经济困难和透析设备欠缺.

Objective To investigate the clinical features and treatment of the end stage renal disease （ESRD） patients in Gansu province.Methods Based on the Chinese national renal data system,the investigation and analysis were made on the epidemiological literature of ESRD patients in 22 hospitals of Gansu from 2012 to 2013 by retrospective investigation.Results （1） In Gansu,the number of living ESRD patients was 4379,the point prevalence rate of ESRD was 169.6 per million.Their average age was （47.46± 15.57） years,30 to 59 years old patients accounted for 70.0%,and the male-female ratio was 1：1.15.The prevalence rate was higher in less-educated population and manual laborers.（2） As the leading cause of ESRD,chronic glomerulonephritis accounted for 43.0%,followe dby diabetic nephropathy （31.0%）,hypertensive nephropathy （11.0%） and allergic diseases （6.9%）.（3） The current treatment of ESRD：51.2% of the patients received hemodialysis,4.4% received peritoneal dialysis,1.1% received renal transplantation,32.2% received no treatment,and 11.1% died.（4） The causes of patients not taking dialytic treatments：economic reasons accounted for 61.0%,lack of blood dialytic conditions accounted for 24.0%,patients ceasing treatment accounted for 3.1%,family factors accounted for 2.3%,religious reasons accounted for 1.8%,other reasons accounted for 7.8%.Conclusions The point prevalence rate of ESRD in Gansu was 169.6 per million.30 to 59 years old patients were the main population.The major cause of ESRD was chronic glomerulonephritis,followed by diabetic nephropathy and hypertensive nephropathy.32.2% of ESRD patients did not receive any renal replacement therapy,which was caused mainly by economic difficulties and the lack of dialytic equipments.