广西城镇与农村慢性肾脏病的流行病学状况比较

目的 了解广西城镇和农村居民慢性肾脏病（CKD）流行情况及危险因素，为临床积极做好CKD防治工作提供有力依据。 方法 采用分层多级抽样方法，对广西18～74岁常住居民进行CKD抽样调查。被调查者均接受问卷调查，检测尿白蛋白/肌酐比值、血尿(离心后尿沉渣显微镜检查)和肾脏B超，结果异常者3个月后进行复查。用国人校正的简化MDRD公式计算估计肾小球滤过率（eGFR）。同时调查CKD的相关危险因素。 结果 城镇和农村居民白蛋白尿标化患病率（5.22%比5.47%）和血尿标化患病率（1.07%比1.11%）差异无统计学意义（均P > 0.05）。农村居民肾结石患病率高于城镇（10.54%比6.95%，P < 0.05）。城镇与农村居民肾功能下降患病率（3.87%比4.04%）和CKD患病率（9.58%比9.42%）差异均无统计学意义（均P > 0.05）。城镇与农村白蛋白尿患病率按年龄分布趋势不同，城镇随年龄增加而增高，农村则有两个发病高峰，年龄分别为30～40岁和60～74岁年龄段。根据Logistic回归分析，广西居民白蛋白尿的危险因素是糖尿病、高尿酸血症、心血管疾病史、慢性扁桃体炎、HBsAg阳性；肾功能下降的危险因素是年龄、高尿酸血症、高血压、糖尿病、肾结石和心血管疾病史。城镇居民CKD知晓率高于农村（14.45％比6.27％，P < 0.05）。 结论 广西城镇与农村居民CKD患病率差异无统计学意义，城镇居民CKD知晓率高于农村，需要加强农村CKD防治工作。

Comparison of epidemiological situation in chronic kidney disease between urban and rural areas in Guangxi province

Objective To investigate and compare the prevalence,awareness and risk factors of chronic kidney disease (CKD) between urban and rural population in Guangxi province in order to provide information for prevention and treatment of CKD. Methods By a stratified multistage random sampling method,18 to 74 years old residents in Guangxi province were surveyed. They were evaluated by questionnaire,urinary albumin/creatinine ratio, hematuria (microscopic examination of centrifuged urine sediment),kidney B-mode ultrasound,and abnormal results were reviewed 3 months later.Estimated glomerular filtration rate (eGFR) was calculated with the simplified MDRD equation modified by a Chinese coefficient.The risk factors associated with CKD were also investigated. Results There were no significant differences between urban and rural residents in the prevalence of albuminuria (5.22％ vs 5.47％) and hematuria (1.07％ vs 1.11％) (all P＞0.05).The prevalence of renal lithiasis in rural residents was significantly higher than that in the town (10.54％ vs 6.95％) (P＜0.05).The decreased renal function between urban and rural residents (3.87％ vs 4.04％,P＞0.05) had no significant difference.The prevalence of CKD was 9.58％ in urban and 9.42％ in rural (P＞0.05).The prevalence of albuminuria according to the age distribution was different between urban and rural,which increased along with the age in urban but showed two peaks (30-40 years old and 60-74 years old) in rural.Based on logistic regression analysis,the risk factors for albuminuria were diabetes,hyperuricemia,the history of cardiovascular disease,chronic tonsillitis and HBsAg positive.The risk factors for kidney function decline were age,hyperuricemia,hypertension,diabetes,renal lithiasis and history of cardiovascular disease.The awareness rate of CKD in urban was significantly higher than that in rural (14.45％ vs 6.27％,P＜0.05). Conclusions The prevalence of CKD has no significant difference between urban and rural in Guangxi province.The awareness rate of CKD in urban is significantly higher than that in rural.It is needed to enhance the prevention and treatment of CKD in rural.