上海市浦东城乡老年人估算肾小球滤过率及危险因素分析

Estimated glomerular filtration rate and the affecting factors in urban and rural elderly in Pudong district of Shanghai

目的探讨城乡结合部老年人群估算肾小球滤过率(eGFR)的异常情况及其发生的危险因素,为延缓慢性肾脏病(CKD)的病程进展提供依据。方法采用横断面调查的方式,在2016年3—5月普查本社区60岁以上的户籍居民5 097名,收集相关体检指标,以2009年慢性肾病流行病学协作组(CKD-EPI)方程计算eGFR,并以eGFR≤60 ml/(min·1.73 m^2)为切点判断慢性肾脏病,应用SPSS 18.0统计软件进行统计,计算人群患病率并分析不同危险因素与疾病的关系。结果 60岁以上老年人平均eGFR为(77.44±19.16)ml/(min·1.73 m^2),同年龄段的性别间的eGFR_(CKD-EPI)水平比较,男性的eGFR_(CKD-EPI)平均值均低于女性,差异有统计学意义(P<0.01);CKD患病数为888人,患病率为17.42%,其eGFR均值为(49.40±9.92)ml/(min·1.73 m^2)。以10岁为间隔进行分组,结果显示,随着年龄上升,eGFR_(CKD-EPI)逐渐降低(P<0.01)。年龄、男性、高血压病和高尿酸是eGFR异常的危险因素(P<0.001)。结论 60岁以上老年人群的CKD患病率较高,尤其是高龄老人,需要关注社区老年人的肾脏疾病和相关危险因素。

Objective To investigate the abnormal situation and affecting factors of estimated glomerular filtration rate （eGFR） in the elderly population in urban-rural integration areas, and to provide basis the treatment of chronic kidney disease（CKD）. Methods In this cross sectional study, we analyzed 5 097 senior permanent residents over 60 years of age between March,2016 and May,2016, collected relevant physical data, estimated GFR using the CKD-EPI Creatinine Equation（2009） ,CKD was defined as an eGFR 〈 60 ml/（ min ·1.73 m^2 ）. The population prevalence and the related risk factors for CKD were analyzed by SPSS 18.0. Results The average eGFR was （77.44 ±19. 16） ml/（ min ·1.73 m^2 ） in the patients over 60 years of age. In the same age group, eGFRCKD-EPI level in the male was lower than that of the female, and there was statistical difference（ P 〈 0.01 ）. 888 were with CKD, and the prevalence rate was 17.42%, and the mean value of eGFR was （49.40 ±9.92） ml/（ min·1.73 m^2 ）. Taking 10 years as the interval, with the age in- creased, eGFRCKD-EPI gradually reduced（ P 〈 0.001 ）. The age, male sex, hypertension and high uric acid were the risk fac- tors for a reduced eGFR（P 〈 0. 001 ）. Conclusion The prevalence of CKD in the elderly over 60 years old is high, espe- cially in the oldest old. The kidney disease and related risk factors should be concerned among the elderly in community.