住院患者慢性肾脏病的危险因素分析

目的：回顾性分析慢性肾脏病（CKD）住院患者肾功能进展的危险因素。方法：收集2001年1月1日～2008年12月31日,在我院肾内科首次住院,未接受替代治疗16岁以上CKD患者655例,分析患者的性别、年龄、血压、原发病、肾穿病理、Hb、Alb、PA、UA、Ca2＋、P3-、TC、TG、LDL、HDL及肾功能进展的危险因素。结果：（1）起病较集中在31岁～60岁,占CKD的53.9%。（2）原发性肾小球疾病、糖尿病、高血压（69.5%、8.9%、8.9%）是导致CKD的主要病因。（3）58.2%患者行肾脏穿刺,病理结果以IgA肾病、系膜增生性肾炎、局灶节段性肾小球硬化、微小病变（31.2%、23.6%、11.3%、10.2%）为主。（4）各期患者血尿存在明显统计学差异（P〈0.01）;蛋白尿差异无统计学意义。与CKD1期比较,除PA、TG外,各期SBP、DBP、Hb、Alb、UA、Ca2＋、P3-、TC、LDL、HDL差异均有统计学意义（P〈0.05）。（5）多元相关回归分析显示eGFR与Hb呈正相关（P〈0.05）,与年龄、血压、UA呈负相关（P〈0.05）。多元Logistic回归分析显示年龄、贫血、高尿酸血症、高血压是CKD肾功能进展的危险因素（P〈0.05）。结论：原发性肾小球肾炎、糖尿病、高血压是主要病因。年龄、贫血、高尿酸血症、高血压为CKD进展的危险因素。

Analysis of Risk Factors in Hospitalized Patients with Chronic Kidney Disease

Objective：To retrospectively investigate the risk factors of the hospitalized patients with chronic kidney disease.Methods：We reviewed the medical histories of 655 adult patients hospitalized in our hospital without any renal replacement therapy.To analysis some factors including the gender、age、pressure、primary disease、eGFR、pathological diagnosis of renal puncture、Hb、Alb、PA、UA、Ca2＋、P3-、CH、TG、LDL、HDL and risk factors of the progress of renal function of the patients.Results：（1）53.9% of the CKD patients＇age was 31 to 60.（2）The most common causes of CKD were primary glomerulonephritis,hypertension and diabetes（69.5%、8.9%、8.9%）.（3）By renal biopsy of the patients（58%）,the most common pathology results were IgA nephropathy,significant difference in hematuria stages（P=0.004）proliferative glomerulonephritis,focal segmental glomerular sclerosis,minimal change based glomerulonephritis（31.2%、23.6%、11.3%、10.2%）.（4）There was with CKD and no difference was existed in proteinuria.In addition to PA,TG,there was significant difference in each stage with SBP,DBP,Hb,Alb,UA,Ca2＋,P3-,CH,LDL,HDL.（5）Multiple correlation regression analysis showed that eGFR and Hb were positively correlated,and age,UA,SBP and DBP were negative correlation （P0.05）.Multiple Logistic regression analysis showed that age,anemia,hyperuricemia and hypertension were the risk factors in the progress of renal function of the chronic kidney disease patients（P0.05）.Conclusion：The most common cause of CKD was primary glomerulonephritis,hypertension and diabetes.Age,anemia,hyperuricemia,hypertension are the common risk factor for the progress of renal function of the chronic kidney disease patients.