连续性非卧床腹膜透析患者血尿酸水平监测对残余肾功能的影响

Effect of serum uric acid level on residual renal function in patients with continuous peritoneal dialysis

目的研究连续性非卧床腹膜透析(CAPD)患者血尿酸(SUA)水平监测对残余肾功能(RRF)的影响。方法采用回顾性分析方法,以2015年1月至2020年1月徐州市肿瘤医院入院的80例CAPD患者为研究对象,参考血尿酸水平分为高尿酸组(n=32)与非高尿酸组(n=48)。两组患者均接受5次访视,收集所有患者的人口学特征、原发病、药物使用情况(别嘌醇、利尿剂、血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂)、生化指标(肌酐清除率、三酰甘油、血清肌酐、血清全段甲状旁腺激素、血磷、超敏C反应蛋白、血红蛋白、总胆固醇、血钙、尿素氮、血白蛋白、血尿酸)。比较两组患者的RRF水平和下降率,分析影响CAPD患者RRF下降的危险因素。结果访视1期至5期,两组患者的RRF水平下降显著,差异有统计学意义(P<0.05),其中高尿酸组下降率达41.34%,非高尿酸组下降率达28.13%,高尿酸组RRF下降率高于非高尿酸组;高尿酸组血尿酸水平变化显著,差异有统计学意义(P<0.05),下降率达22.72%,而非高尿酸组血尿酸水平变化差异无统计学意义(P>0.05)。高尿酸组血尿酸水平与RRF的单因素、多元素分析显示,CAPD患者RRF下降的独立危险因素为高尿酸血症(HUA)。结论血尿酸水平过高可引起CAPD患者RRF下降,且以HUA为影响CAPD患者RRF的独立危险因素。

Objective To investigate the effect of serum uric acid(SUA)level on residual renal function(RRF)in patients with continuous peritoneal dialysis(CAPD).Methods By retrospective analysis,80 CAPD patients admitted to Xuzhou Cancer Hospital from January 2015 to January 2020 were selected as the study subjects.Based on SUA level,they were divided into high uric acid group(n=32)and non-high uric acid group(n=48).Patients in both groups received 5 visits.All patients'demographic characteristics,the primary disease,drug usage(don't Piao alcohol,diuretics,angiotensin converting enzyme inhibitor/angiotensinⅡreceptor antagonist),biochemical indicators(three acyl glycerin,serum creatinine,creatinine clearance,the entire section parathyroid hormone and blood serum phosphorus,hypersensitive c-reactive protein,hemoglobin,total cholesterol,blood calcium and blood urea nitrogen,white eggs White,SUA)were collected.RRF levels and rates of decline were compared between the two groups,and risk factors for RRF decline in CAPD patients were analyzed.Results During the visit,RRF of the two groups were significantly changed,the differences were statistically significant(P<0.05).The decrease rate of RRF in the high uric acid group was 41.34%from the first to the fifth visit,and that in the non-high uric acid group was 28.13%.The RRF decrease rate in the high uric acid group was higher than that in the non-high uric acid group.The changes of SUA level in the high uric acid group were statistically significant(P<0.05),and the decrease rate from the first to the fifth visits was 22.72%,while the changes of SUA level in the non-high uric acid group were not statistically significant(P>0.05).Univariate and multivariate analysis of SUA level and RRF in the high uric acid group showed that the independent risk factor for RRF decline in CAPD patients was hyperuricemia(HUA).Conclusion High SUA level can cause RRF decline in CAPD patients,and HUA is an independent risk factor.