非透析慢性肾脏病患者高尿酸血症的危险因素分析

Risk factors of hyperuricemia in patients with non-dialytic chronic kidney disease

目的探讨和分析非透析慢性肾脏病(non-dialysis chronic kidney disease,ND-CKD)患者高尿酸血症(hyperuricemia,HUA)的发生率及其相关危险因素。方法收集2015年1月至2019年12月于山西医科大学第二医院肾内科就诊的540例ND-CKD患者的临床资料,依据HUA的诊断标准(男性>420μmol/L,女性>360μmol/L),分为HUA组(n=295)与非HUA组(n=245)。比较两组患者的临床资料,采用Logistic回归法分析ND-CKD患者发生HUA的危险因素。结果540例ND-CKD患者中,HUA的发生率为54.6%,其中CKD 1~5期患者HUA的发生率分别为31.7%、50.5%、58.7%、64.3%、76.3%。多因素Logistic回归分析显示,男性(OR=1.583,95%CI 1.018~2.461,P<0.05)、CKD分期(OR=1.501,95%CI 1.230~1.832,P<0.01)、高血压病(OR=1.632,95%CI 1.020~2.611,P<0.05)、BMI(OR=1.111,95%CI 1.042~1.186,P<0.01)、血磷(OR=5.947,95%CI 2.589~13.658,P<0.01)、年龄(OR=0.971,95%CI 0.957~0.985,P<0.01)是ND-CKD患者发生HUA的独立危险因素。结论随着CKD分期的进展,HUA的发生率逐渐增高,重视CKD患者HUA的发生并针对危险因素早期进行干预,可延缓CKD进展。

Objective To explore the prevalence and risk factors of hyperuricemia(HUA)in patients with non-dialytic chronic kidney disease(ND-CKD).Methods Clinical data were collected for 540 patients with confirmed ND-CKD between January 2015 and December 2019.They were divided into HUA group(n=295)and non-HUA group(n=245)according to the definition of hyperuricemia(male>420 μmol/L,female>360 μmol/L).Clinical data of two groups were compared.Logistic regression analysis was employed for identifying the risk factors of HUA in ND-CKD patients.Results The prevalence of HUA was 54.6%.And the incidence of HUA in CKD stage 1~5 patients was 31.7%,50.5%,58.7%,64.3% and 76.3%.Multivariate stepwise logistic regression analysis revealed that male(OR=1.583,95%CI 1.018~2.461,P<0.05),CKD staging(OR=1.501,95%CI 1.230~1.832,P<0.01),hypertension(OR=1.632,95%CI 1.020~2.611,P<0.05),body mass index(OR=1.111,95%CI 1.042~1.186,P<0.01),blood phosphorus(OR=5.947,95%CI 2.589~13.658,P<0.01)and age(OR=0.971,95%CI 0.957~0.985,P<0.01)were the independent risk factors of HUA in ND-CKD patients.Conclusions The incidence of HUA rises gradually with a higher stage of CKD.Paying close attention to the occurrence of HUA in ND-CKD patients and taking early interventions risk factors may delay the progression of disease.