| 慢性肾脏病人群中高尿酸血症的患病率及危险因素研究 |
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| 引用本文： | 胡艳,陶敏,潘星,马晓燕,庄守纲,刘娜,方路.慢性肾脏病人群中高尿酸血症的患病率及危险因素研究[J].中华全科医学,2020,18(12):1989-1993. |
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| 作者姓名： | 胡艳 陶敏 潘星 马晓燕 庄守纲 刘娜 方路 |
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| 作者单位： | 1. 同济大学附属东方医院肾内科, 上海 200092; |
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| 基金项目： | 江西省卫计委课题(20184077)81200492)浦东新区重点学科附带课题(PWZxk2017-05)81470991国家自然科学基金(81670690 |
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| 摘 要： | 目的 探讨同济大学附属东方医院和上海市东方医院吉安医院肾内科住院的慢性肾脏病(chronic kidney disease, CKD)人群中高尿酸血症的患病率及危险因素,为CKD患者合并高尿酸血症的防治提供临床依据。 方法 选取2017年1月1日—2019年7月31日在同济大学附属东方医院(上海市)和上海市东方医院吉安医院(江西省吉安市)住院的436例CKD患者,按K/DOQI指南分为CKD 1~5期组,分析不同CKD分期人群的高尿酸血症患病情况及相关危险因素。 结果 不同CKD分期患者高尿酸血症患病率不同,差异具有统计学意义(P<0.001)。多因素logistic回归分析显示在CKD患者中,舒张压(OR=1.025,95%CI:1.005~1.044,P=0.012)为高尿酸血症的危险因素,血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB,OR=0.536,95%CI:0.335~0.859,P=0.009)和肾小球滤过率(eGFR,OR=0.988, 95%CI:0.980~0.997,P=0.005)为高尿酸血症的保护性因素。CKD 4期较CKD 1期患高尿酸血症的比值比OR最大,为4.385(95%CI:1.655~11.621,P=0.003)。 结论 慢性肾脏病患者中,舒张压升高为高尿酸血症的危险因素,服用ACEI/ARB药物以及较高的肾小球滤过率为高尿酸血症的保护性因素。CKD的疾病进展与高尿酸血症有明显的相关性,这提示积极控制血压、保护肾脏功能将有利于降低高尿酸血症的发生,而降尿酸治疗可能也有利于保护残肾功能,并改善CKD患者的预后。
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| 关 键 词： | 慢性肾脏病 高尿酸血症 患病率 危险因素 |
| 收稿时间： | 2019-12-15 |
Prevalence and risk factors of hyperuricemia in patients with chronic kidney disease |
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| Affiliation: | Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, China |
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| Abstract: | Objective To explore the prevalence and risk factors of hyperuricemia in patients with chronic kidney disease(CKD) hospitalized in Shanghai East Hospital and Ji'an Hospital of Shanghai East Hospital, and to provide clinical reference for the prevention and treatment of hyperuricemia in CKD patients. Methods Total 436 CKD patients hospitalized in East Hospital Affiliated to Tongji University(Shanghai) and Shanghai East Hospital Ji'an Hospital(Ji'an, Jiangxi) from January 1, 2017 to July 31, 2019 were divided into CKD 1 to 5 groups according to K/DOQI guidelines. The prevalence of hyperuricemia and related risk factors in different CKD stages were analyzed. Results The prevalence of hyperuricemia in patients with different CKD stages is different, and the difference was statistically significant(P<0.001). Multivariate logistic regression analysis showed that diastolic blood pressure(OR=1.025, 95% CI: 1.005-1.044, P=0.012) was a risk factor for hyperuricemia, while ACEI/ARB(OR=0.536, 95% CI: 0.335-0.859, P=0.009) and estimated glomerular filtration rate(eGFR, OR=0.988, 95% CI: 0.980-0.997, P=0.005) were protective factors for hyperuricemia. Compared with the CKD 1 stage group, the ORs of hyperuricemia of the CKD 4 stage group was the highest, 4.385(OR=4.385, 95% CI: 1.655-11.621, P=0.003). Conclusion Among CKD patients, the increase of diastolic blood pressure is the risk factor of hyperuricemia, while taking ACEI/ARB drugs and higher glomerular filtration rate are the protective factors for hyperuricemia. The progress of CKD is significantly correlated with hyperuricemia, suggesting that controlling blood pressure and protection of glomerular filtration rate in patients with CKD are of great significance in the prevention and treatment of hyperuricemia. Controlling the level of serum uric acid may benefit to improve the residual renal function and the prognosis of CKD. |
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