浙江省某乡村慢性肾脏病的流行病学研究

目的 研究我国南方某农村人群中慢性肾脏病（CKD）的患病率及相关因素。方法 对浙江省东阳市某乡村18岁以上的常住居民慢性肾脏病情况及相关因素进行调查和检测。结果 获得完整资料的居民占该村18岁以上自然人口的76．2％。将该村自然人口按年龄性别构成校正后，白蛋白尿发生率为10．4％；肾小球滤过率〈60ml·min^-1·（1．73m^2）^-1的发生率为3．0％；血尿发生率为1．4％。本研究中40岁以上调查对象与北京市某社区及NHANESⅢ中40岁以上调查对象相比，高血压及糖尿病的患病率较低，白蛋白尿和肾功能下降的发生率介于2者之间。多因素Logistic回归提示，年龄增加10岁、糖代谢异常及收缩压水平与白蛋白尿的发生独立相关；女性、年龄增加10岁、高尿酸血症与肾功能下降独立相关；年龄增加10岁及吸烟与血尿独立相关。结论 在该经济快速发展的南方乡村，CKD的疾病谱和相关因素已经与我国大城市和发达国家类似。此外，该人群可能另有导致CKD高发的特殊原因，需进一步研究。

Screening for chronic kidney disease in a village of Zhejiang province

Objective To investigate the prevalence of chronic kidney disease(CKD) and associated factors in a village of Zhejiang province. Methods All residents older than 18 years in the village were interviewed and screened for albuminuria with morning spot urine albumin to creatinine ratio (abnormal:≥30 mg/g), reduced renal function with estimated glomerular filtration rate by modified MDRD equation [abnomal: <60 ml·min-1·（173 m2)-1; hematuria with morning spot urine dipstick confirmed by urine sediments microscopy test. The correlations among demographic characteristics, health characteristics (eg. smoking, diabetes and hypertension) and indicators of kidney damage were examined. Results Complete information was obtained in 76.2% of the residents. After age and gender adjustment, the prevalence of albuminuria, reduced renal function and hematuria was 10.4%, 3.0% and 1.4%, respectively. Compared with subjects older than 40 years in Beijing and NHANES Ⅲ, participants older than 40 years in the present study tended to have lower prevalence of diabetes and hypertension, and higher prevalence of albuminuria and reduced renal function. Age and diabetes and systolic blood pressure were independently correlated with albuminuria. Female, age and hyperuricemia were independently correlated with reduced renal function. Age and smoking were independently correlated with reduced renal function. Conclusion The spectrum and correlated factors of CKD in a village undergoing rapidly economic development are close to those of Beijing and developed countries, while certain specific factors might contribute to the high prevalence of CKD in the present village.