ISSN 1006-298X      CN 32-1425/R

导航

肾脏病与透析肾移植杂志 ›› 2024, Vol. 33 ›› Issue (6): 541-546.DOI: 10.3969/j.issn.1006-298X.2024.06.007

• 论著 • 上一篇    下一篇

成都市某社区新诊断慢性肾脏病人群的流行病学特征

  

  • 出版日期:2024-12-28 发布日期:2025-01-03

Epidemiological characteristics of newly diagnosed chronic kidney disease patients in a community in Chengdu#br#

  • Online:2024-12-28 Published:2025-01-03

摘要: 目的:了解成都市某社区就诊人群中新诊断慢性肾脏病(CKD) 的筛查现状,并探讨其患病的主要影响因素,为 CKD 的社区防治提供客观依据。 方法:回顾性分析 2014⁃04⁃17~2023⁃04⁃16 就诊并签署家庭医生签约服务合同人群资料, CKD 诊断标准:(1) 肾脏损害≥3 月;(2) 连续 2 次 eGFR<60 mL/(min·1.73m2 ) ,时间≥3 月或(3) 连续 2 次尿微量白蛋白≥30  mg/g,时间≥3 月。  排除既往已明确诊断为 CKD、数据缺失和年龄≤18岁者。  采用单因素和多因素 Logistic 回归分析筛选影响 CKD 发生的独立因素。      结果:共纳入 8 114 例社区人群,93.65% 为 CKD 高危人群, 其 CKD 危险因素最常见的为高龄(74.11%) 、高血压  (67.50%) 、肥胖(51.85%) 、糖尿病(32.09%) 。 6 086 例患者完成 CKD 筛查,有 357 例(5.87%) 被判定为 CKD,其中 82.91% 患者处于早期(G1、G2) 阶段;58 例(16.25%) eGFR< 60  mL/(min·1.73  m2 ) ,299 例(83.75%) 为尿蛋白异常。  高血压者 CKD 发病率高于未患高血压者(P<0.01) ;糖尿病者 CKD 发病率高于未患有糖尿病者(P<0.01) 。      结论:高血压和糖尿病是 CKD 患病的影响因素,年龄越大、患有基础疾病的人群 CKD 的患病率越高,检测手段的差异会影响 CKD 的检出率。

Abstract: Objective:To investigate the current status  of  screening  for  newly  diagnosed Chronic  Kidney  Disease (CKD)  among  the  population  seeking  medical  care  in  a  specific  community  in  Chengdu,  and  to  explore  the  primary influencing factors of  its  occurrence,  thereby  providing  objective  evidence  for  community⁃based  prevention  and  control  of chronic kidney disease.    Methodology:A retrospective analysis was conducted on the data of patients who visited the clinic and signed family doctor service contracts between April 17, 2014, and April 16, 2023. The diagnostic criteria for Chronic Kidney  Disease (CKD) were as follows: (1) Renal damage lasting for≥3 months; (2) Two consecutive eGFR values <60 mL/(min·1.73 m2 )  with an interval ≥3 months; (3)  Two consecutive urine microalbumin ≥30 mg/g with an interval ≥3 months. Patients with a prior diagnosis of CKD, missing data, and those aged≤18 years were excluded. Univariate and multivariate Logistic  regression  analyses  were  performed  to  screen  for  independent  factors  influencing  the  occurrence  of CKD.    Results:A total of 8 114 individuals  from the  community  were  included, with 93.65%  belonging  to  the  high⁃risk group for  CKD.  The  most  common  risk  factors  for  CKD  among  them  were  advanced  age  (74.11%),  hypertension (67.50%),  obesity  (51.85%),  and  diabetes  (32.09%).  Among  the  6, 086  participants  who  completed  the  kidney screening, a total of 357 (5.87%)  were diagnosed with CKD. Of these, 82.91%  were in the early stages (G1, G2); 58 patients (16.25%)  had an estimated glomerular  filtration rate  (eGFR)  of  less  than 60  mL/(min·1.73  m2 ), and 299 patients (83.75%)  had abnormal urine protein levels.  The incidence of CKD was higher  in individuals  with hypertension compared to those without (P<0.01); similarly, the incidence was higher in those with diabetes compared to those without diabetes (P < 0.01).     Conclusion: Hypertension  and  diabetes  are  contributing  factors  to  the  development  of  CKD.  The incidence of  CKD  is  higher  in  populations  with  older  age  and  underlying  medical  conditions.  Differences  in  detection methods can affect the rate of CKD identification.

Key words: chronic kidney disease   , community screening   , influencing factors   , Chengdu