苏州市斜塘社区高尿酸血症人群慢性肾脏病筛查及危险因素分析

Prevalence and Risk Factors of Chronic Kidney Disease in People with Hyperuricemia in Xietang Community of Suzhou

目的通过对社区体检人群筛查,了解苏州市社区高尿酸血症人群慢性肾脏病(CKD)的患病情况及危险因素。方法选取2020年9月—12月至斜塘街道社区卫生服务中心进行50岁以上健康体检的8602名人群为研究对象,通过问卷、体检和实验室检查收集人群的临床数据,对高尿酸血症人群进行CKD筛查。结果社区人群高尿酸血症的患病率为16.3%,高尿酸血症人群的CKD患病率显著高于非高尿酸血症人群(P<0.001)。高尿酸血症人群血尿酸每升高60μmol/L,血尿、eGFR下降和CKD患病率均显著增加(P<0.001)。高尿酸血症患者年龄每增加10岁,蛋白尿、血尿、eGFR下降和CKD患病率均显著增加(P<0.001)。高尿酸血症同时合并糖尿病和高血压患者的蛋白尿、eGFR下降和CKD患病率显著高于其他人群(P<0.05)。高龄、肾结石以及合并高血压和糖尿病两种疾病是高尿酸血症患者CKD患病的独立危险因素。结论苏州市社区高尿酸血症人群中CKD的患病率较高,与血尿酸水平有关。高龄、肾结石以及合并高血压和糖尿病两种疾病是高尿酸血症患者CKD患病的独立危险因素。预防结石发生,控制血糖、血压,有助于减少CKD的发生发展。

Objective To investigate the prevalence of chronic kidney disease(CKD)and associated risk factors in people with hyperuricemia in Xietang Community of Suzhou.Methods A total of 8602 participants aged≥50 years who had a health check-up from September 2020 to December 2020 in Xietang Community Health Service Center were enrolled.Participants were screened for CKD.The clinical data from the population were collected by questionnaire,physical examination and laboratory examination.Results The prevalence of hyperuricemia in the community was 16.3%.The prevalence of CKD in people with hyperuricemia was significantly higher than in non-hyperuricemia population(P<0.001).Prevalence of hematuria,reduced eGFR and CKD were obviously increased with every 60μmol/L uric acid increase.For every 10 years of age increased,there was a significant increase in proteinuria,hematuria,reduced eGFR and CKD prevalence(P<0.001).The prevalence of albuminuria,reduced eGFR and CKD were significantly higher in patients with hyperuricemia combined diabetes and hypertension than those in other populations(P<0.05).Old age,kidney stones,combined with hypertension and diabetes are independent risk factors for CKD in patients with hyperuricemia.Conclusion The prevalence of CKD in people with hyperuricemia in the community of Suzhou was high,which was related to the level of uric acid.Old age,kidney stones,combined with hypertension and diabetes are independent risk factors for CKD.Preventing kidney stones,controlling blood glucose and blood pressure can help to reduce the occurrence and development of CKD in patients with hyperuricemia.