慢性肾脏病患病及进展危险因素分析

Risk factors for the onset and progression of chronic kidney disease

目的分析健康体检中发现的慢性肾脏病(CKD)患病及进展危险因素。方法选取2011年1月—2012年1月期间在该院接受体检的职工16 759例的临床资料,分析CKD患病率及患病危险因素,并采用前瞻性队列研究,分析疾病进展因素。结果在16 759例资料完整的体检人群中,蛋白尿检出率3.41%,血尿检出率17.93%,排除尿路感染等因素造成的影响,血尿12.3%,血肌酐升高检出率0.24%,肾脏B超影像学异常检出率11.2%,其中B超肾脏体积缩小0.21%。总体检人群中CKD检出率为7.61%,多因素分析,结果显示男性、年龄、高血压、高脂血症、糖尿病、体质量指数、高尿酸血症是CKD患病的危险因素;经多因素分析校正后,基线肾小球滤过率(e GFR)低、蛋白尿、基础病为糖尿病及治疗依从性差是该组病人肾功能进展独立危险因素。结论慢性肾脏病患病及进展危险因素不尽相同,加强在高危人群中筛查,做到早发现,早干预,预防CKD发生,延缓CKD进展。

Objective To analyze the risk factors of the onset and progression of chronic kidney disease （CKD） found in health check-up. Methods The examination data of 16 759 workers who received health check-up at Shanghai Meishan Hospital from January 2011 to January 2012 were collected to analyze the morbidity of CKD and its risk factors. A prospective cohort study was also made to analyze the risk factors for the progression of CKD. Results Among the 16 759 healthy persons with complete checkup records,the detection rates of proteinuria and hematuria were 3.41% and 17. 93% Respectively. The detection rate of hematuria was 12. 3% with the excep-tion of the hematuria due to urinary tract infection. The detection rate of increased blood Cr was 0. 24% . The detection rate of abnormal ultrasonic imaging of the kidney was 11. 2% , of which kidney shrinkage accounted for 0. 21%. The detection rate of CKD among all checkup population was 7. 61%. The multivariate analysis revealed that male, age, hypertension, hyperlipemia, diabetes, body mass in-dex and hyperuricemia were the risk factors for the onset of CKD. After multivariate adjustment,the low GFR at baseline,proteinuria,di-abetes and poor compliance with treatment were independent risk factors for the progression of CKD. Conclusions The risk factors for the onset and progression of chronic kidney disease are different, therefore, screening should be strengthened among the high-risk popu-lations of CKD,so as to achieve early detection and intervention to prevent the occurrence and delay the progression of CKD.