尿酸排泄分数与肾病分期关系研究

The relationship between the stages of chronic kidney disease and fractional excretion of uric acid

目的:探究慢性肾脏病(chronickidney disease,CKD)患者尿酸排泄分数,(fraction excretion ofuric acid,FEUA)与肾病分期关系。方法:选取2021年8月-2022年3月就诊于顺义区医院肾内科的92名患者为研究对象。根据估算肾小球滤过率(estimatedglomerularfiltrationrate,eGFR)分为5期,(CKD1-5),比较不同分期CKD患者一般资料及FEUA临床分型指标的差异;采用Spearman相关性分析FEUA和eGFR与血尿酸、血肌酐、24小时尿蛋白的关系;对FEUA影响因素进行分层分析及多元线性回归分析。结果:随着CKD分期增加,患者FEUA水平、血肌酐、24h尿蛋白均逐渐增加。CKD1、2期患者以排泄减少型为主,CKD3期患者以混合型为主,CKD4、5期患者以生成增多型为主。Spearman相关分析显示,eGFR和FEUA呈负相关、(P<0.0001)。年龄≥60岁、高血压组以及生成增多型患者有相对高的FEUA和相对低的eGFR。多元线性回归分析结果表明,FEUA的影响因素是eGFR和血尿酸(t=-8.151,t=-5.856,P均<0.001)。结论:不同分期CKD患者尿酸排泄水平存在差异,随着CKD疾病进展,患者FEUA水平逐渐增加。CKD早期患者以排泄减少型为主,CKD晚期患者以生成增多型为主。在治疗前及治疗期间监测FEUA是非常必要的。

Objective:To investigate the relationship between fractional excretion of uric acid(FEUA)and the stages of chronic kidney disease in patients.Methods:The research involved 92 patients admitted into nephrology department of Shunyi District Hospital from August 2021 to March 2022.According to the estimated glomerular filtration rate(eGFR),patients were classified into CKD1-5 stages.The differences of general data and FEUA clinical classification indexes in each stage of CKD patients were analyzed.Spearman correlation was used to analyze the relationship between FEUA and eGFR with serum uric acid,serum creatinine and 24-hour urine protein.The influencing factors of FEUA were analyzed by stratification and multiple linear regression.Results:With the increase of CKD stage,the level of FEUA,serum creatinine and 24h urinary protein allincreased gradually in patients.The patients in CKD1,2 stages were mainly underexcretion-type,the patients in CKD3 stage were mainly combined-type,and the patients in CKD4,5 stages were mainly overproduction-type.Spearman correlation analysis showed that eGFR and FEUA were negatively correlated(P<0.0001).Patients with age≥60 years,hypertension and overproduction-type had relatively high FEUA and relatively low eGFR.Multiple linear regression analysis showed that the influencing factors of FEUA were eGFR and serum uric acid(t=-8.151,t=-5.856,P<0.001).Conclusion:There are differences in the level of uric acid excretion in patients with different stages of CKD.With the progression of CKD,the level of FEUA in patients gradually increased.Patients in early stage of CKD are mainly of underexcretion-type,and patients in late stage of CKD are mainly of overproduction-type.This suggests that monitoring FEUA before and during treatment is essential.