乌鲁木齐市天山区35岁以上成人慢性肾脏病流行病学调查及相关因素分析

目的 了解乌鲁木齐市天山区35岁以上成人慢性肾脏病（CKD）的流行病学特征及危险因素。 方法 以分层多级整群抽样法,对乌鲁木齐市天山区4个社区的2131名35岁以上常住居民进行问卷调查、体格检查和实验室检查。 结果 在2131名资料完整的居民中,经年龄、性别校正后,白蛋白尿的患病率为2.63%（95%CI：1.78%~3.48%）;血尿的患病率为7.43%（95%CI：6.11%~8.75%）;肾功能下降的患病率为1.72%（95%CI：1.08%~2.35%）。该人群CKD的患病率为9.99%（95%CI：8.47%~11.55%）,知晓率为2.44%。多因素Logistic回归显示,白蛋白尿、血尿、年龄增加10岁、高尿酸血症与肾功能下降独立相关;血尿、肾功能下降与白蛋白尿独立相关;白蛋白尿、肾功能下降、女性与血尿独立相关。 结论 作为中国西部大城市,乌鲁木齐市35岁以上成人CKD的患病率为9.99%,知晓率为2.44%;CKD的危险因素与我国大城市及西方发达国家类似。     

乌鲁木齐市天山区35岁以上成人慢性肾脏病流行病学调查及相关因素分析

Objective To investigate the prevalence of chronic kidney disease (CKD)and risk factors in the adult population of Tianshan district in Urumqi, Xinjiang. Methods A total of 2131 residents from 4 communities in Tianshan district of Urumqi city were randomly selected using a stratified, multistage sampling. All the residents were interviewed and tested for morning spot urine of albumin to creatinine ratio (ACR) (abnormal ≥ 30 mg/g), morning spot urine dipstick of hematuria ( abnormal ＞3 red blood cells/HP or greater) and pyuria ( abnormal＞ 5 white blood cells/HP) confirmed by microscopy. Renal function was determined with abbreviated MDRD equation [reduced estimated glomerular filtration rate (eGFR)＜60 ml ·min-1 ·(1.73 m2)-1]. The associations of kidney damage indicators with age, gender, hypertension, diabetes mellitus, income,education, cholesterol, triglyceride and smoking were examined. Results Eligible data of 2131 subjects were collected in the study. After the adjustment of age and gender component, the prevalence of albuminuria was found in 2.63％ (95％CI:1.78％-3.48％) of subjects, hematuria in 7.43％(95％CI:6.11％-8.75％) and reduced renal function in 1.72％(95％CI:1.08％-2.35％).Approximately 9.99％(95％CI:8.47％-11.55％) of subjects had at least one indicator of kidney damage. Multivariate logistic regression revealed that albuminuria, hematuria, age and hyperuricemia were independently associated with reduced renal function. Hematuria and reduced renal function were independently associated with albuminuria. Albuminuria, reduced renal function and female were independently associated with hematuria. Conclusion In urban adult population over 35 years old of Urumqi, a big city in western China, the prevalence of CKD is 9.99％, the recognition is 2.44％ and the risk factors of CKD are similar to those of other domestic big cities and western developed countries.     

乌鲁木齐市天山区35岁以上成人慢性肾脏病流行病学调查及相关因素分析

Objective To investigate the prevalence of chronic kidney disease (CKD)and risk factors in the adult population of Tianshan district in Urumqi, Xinjiang. Methods A total of 2131 residents from 4 communities in Tianshan district of Urumqi city were randomly selected using a stratified, multistage sampling. All the residents were interviewed and tested for morning spot urine of albumin to creatinine ratio (ACR) (abnormal ≥ 30 mg/g), morning spot urine dipstick of hematuria ( abnormal ＞3 red blood cells/HP or greater) and pyuria ( abnormal＞ 5 white blood cells/HP) confirmed by microscopy. Renal function was determined with abbreviated MDRD equation [reduced estimated glomerular filtration rate (eGFR)＜60 ml ·min-1 ·(1.73 m2)-1]. The associations of kidney damage indicators with age, gender, hypertension, diabetes mellitus, income,education, cholesterol, triglyceride and smoking were examined. Results Eligible data of 2131 subjects were collected in the study. After the adjustment of age and gender component, the prevalence of albuminuria was found in 2.63％ (95％CI:1.78％-3.48％) of subjects, hematuria in 7.43％(95％CI:6.11％-8.75％) and reduced renal function in 1.72％(95％CI:1.08％-2.35％).Approximately 9.99％(95％CI:8.47％-11.55％) of subjects had at least one indicator of kidney damage. Multivariate logistic regression revealed that albuminuria, hematuria, age and hyperuricemia were independently associated with reduced renal function. Hematuria and reduced renal function were independently associated with albuminuria. Albuminuria, reduced renal function and female were independently associated with hematuria. Conclusion In urban adult population over 35 years old of Urumqi, a big city in western China, the prevalence of CKD is 9.99％, the recognition is 2.44％ and the risk factors of CKD are similar to those of other domestic big cities and western developed countries.     

河南省郑州市成年人血糖异常分布与慢性肾脏病的流行病学研究

目的 了解郑州市区居民血糖异常分布情况,探讨血糖异常分布与慢性肾脏病的关系。 方法 从2007年“郑州市成年人慢性肾脏病（CKD）及其危险因素流行病学调查”资料中,取有完整资料的1593人（男性659人,女934人）列入本次研究,根据相关疾病诊断标准对资料进行分析。 结果 郑州市≥20岁居民空腹血糖异常及糖尿病粗患病率分别为30.26%和6.15%,标化患病率为30.76%和6.20%,男性血糖异常患病率高于女性（χ2 = 8.040,P = 0.005）。按年龄分组后,空腹血糖异常患病率随年龄增长而增加（χ2 = 5.571,P = 0.018）。该人群中蛋白尿、血尿、估算肾小球滤过率（eGFR）下降和CKD总体患病率分别为5.64%、6.32%、1.59%和11.51%,其中糖尿病组的白蛋白尿及CKD患病率较高,分别为19.39%和28.57%,显著高于空腹血糖正常组和异常组（P ＜ 0.05）,且随着病程的延长而升高（χ2 = 37.263,P ＜ 0.01）。 结论 郑州市20岁以上人群血糖异常、糖尿病具有较高的患病率,为30.76%和6.20%,且与CKD患病率有一定关系。     

新疆墨玉县维吾尔族血糖异常分布与慢性肾脏病的流行病学调查

目的：了解和田墨玉县农村维吾尔族成人居民血糖异常分布情况,分析血糖异常分布与慢性肾脏病（ CKD）的关系。方法：从“新疆墨玉县农村维吾尔族成人 CKD 流行病学调查”资料库中,获取资料完整的1552人用于分析。结果：和田墨玉县18岁以上居民空腹血糖（FPG）异常及糖尿病初患病率分别为27．51%（95% CI：27．47-27．85）和4．19%（95%CI：3．19-5．18）,年龄、性别标化率：27．66%（95% CI：27．47-27．85）和4．35%（95% CI：4．27-4．44）,FPG 异常及糖尿病患病率随年龄增长而升高（ P ﹤0．05）。FPG 正常组,FPG 异常组和糖尿病组的白蛋白尿和 CKD 患病率分别为（3．30%,5．85%,10．77% vs 3．96%,7．03%,12．31%）,且随 FPG 水平增高而升高（P ﹤0．01）。FPG 异常合并高血压或高三酰甘油血症时,CKD 患病率相应增高。结论：血糖分布异常和 CKD 相关,关注糖尿病的同时,应重视 FPG 异常并控制高血压,高三酰甘油血症等因素。     

安徽省成人慢性肾脏病流行病学调查

目的 探讨安徽省成人慢性肾脏病(CKD)患病率及相关危险因素.方法 采用分层多级抽样的方法随机抽取安徽省18岁以上常住居民3800人,进行CKD及相关危险因素的检测和问卷调查.结果 在资料完整的3374名居民中,经人口年龄、性别构成比校正后,白蛋白尿患病率为9.8％(95％CI 8.8％～10.9％);肾功能下降患病率为2.1％(95％CI 1.7％～2.7％).该人群CKD患病率为10.4％(95％CI 9.4％～11.5％);知晓率为6.5％.女性、年龄增加、糖尿病、高血压和高尿酸血症是CKD的独立危险因素,而肥胖、高脂血症、吸烟和饮酒与CKD发病率增高无关.结论 安徽省成人CKD患病率为10.4％,知晓率为6.5％.女性、年龄增加、高血压、糖尿病及高尿酸血症是CKD的独立危险因素.     

不同降血糖方法对糖尿病肾脏病患者血糖及尿蛋白排泄率的影响

目的 比较早期糖尿病肾脏病患者接受不同降血糖方法治疗后血糖波动及尿蛋白排泄率（UAER）情况,探讨该期患者应用胰岛素治疗对于病程进展的预防及治疗作用.方法 选择128例糖尿病肾脏病患者,入选时肾小球滤过率（GFR）处于慢性肾脏病（CKD）1～3期,分为A组60例、B组68例;分别给予胰岛素治疗和非胰岛素治疗,对治疗结果进行分析比较,评判不同降血糖方法的疗效及影响因素.结果 A组血糖漂移度较B组显著降低（P＜0.05）A、B组UAER分别为（82.5±19.6）μg/min和（65.7±21.1） μg/min,2组比较有统计学差异（P＜0.05）.结论 应用胰岛素治疗能更好控制血糖水平,有效减缓肾脏病变进展速度,是预防及治疗糖尿病肾脏病的有效方法.     

山西省右玉县城镇成人慢性肾脏病的流行病学研究

目的 研究山西省右玉县城镇成人慢性肾脏病（CKD）的患病率及其影响因素,以便提出相应的防治措施。 方法 采用随机整群抽样的方法抽取右玉县城18岁以上的居民3603名进行CKD及其影响因素的问卷调查和相关检测。 结果 （1）资料完整的为3502名,经年龄和性别校正后,白蛋白尿患病率为6.8%（95%CI：6.5%～7.1%）;血尿患病率为7.1%（95%CI：6.8%～7.4%）;估算肾小球滤过率（eGFR）下降患病率为2.0%（95%CI：1.8%～2.2%）。该人群CKD患病率为15.1%（95%CI：14.5%～15.5%）,知晓率为6.9%。（2）女性白蛋白尿、血尿和eGFR下降的患病率均显著高于男性（均P ＜ 0.01）。（3）白蛋白尿、eGFR下降和CKD患病率均随年龄增加而逐渐增加,男女均有同样趋势（均P ＜ 0.01）,而总体血尿与年龄无关。（4）多因素Logistic回归分析显示,白蛋白尿与性别、糖代谢异常、高脂血症、肾病史及心血管疾病史独立相关;eGFR下降与性别、年龄、高血压、糖代谢异常、肾病史、肾病家族史及白蛋白尿独立相关;血尿与性别相关。 结论 山西省右玉县城镇成人的CKD患病率较高,危险因素与国内发达城市和西方国家类似。在经济不太发达地区开展CKD防治工作更为迫切。     

内蒙古呼伦贝尔地区成人慢性肾脏病流行病学调查

目的 探讨我国内蒙古自治区呼伦贝尔少数民族聚居区成年人群中慢性肾脏病（CKD）患病率及其危险因素。 方法 对该地区20岁以上常住居民进行CKD抽样调查,被调查者均检测了尿白蛋白/肌酐比率、血尿（离心后尿沉渣显微镜检查）及估计肾小球滤过率（eGFR,检验血清肌酐后用国人校正的简化MDRD公式计算）;并同时调查了CKD的相关危险因素。 结果 符合入选条件的被调查者共4522例,白蛋白尿阳性率为7.11%;血尿阳性率为2.64%;eGFR低于60 ml•min-1•(1.73 m2)-1者为2.75%;去除白蛋白尿、血尿及eGFR下降共同存在造成的重复,该地区CKD患病率为12.95%。高血压患病率38.90%,糖代谢异常6.61%,脂代谢异常34.60%,腰围增大24.79%,代谢综合征15.02%。多因素Logistic回归分析及分层分析显示,年龄增加、腰围增大、收缩压升高、空腹血糖升高、血清三酰甘油增高及患代谢综合征与白蛋白尿发生相关;年龄增加、收缩压升高及空腹血糖升高与肾功能下降相关;年龄增加与血尿发生相关。 结论 内蒙古自治区呼伦贝尔地区CKD患病率为12.95%。相关危险因素包括年龄增加、腰围增大、高血压、血糖或血脂异常、及代谢综合征。     

天水市城区中老年以上人群慢性肾脏病流行病学研究

近年来,随着高血压病、糖尿病、代谢综合征等疾病发病率的上升,慢性肾脏（CKD）也呈现出上升的趋势。CKD病情隐匿,进展缓慢,大多数患者发现时病情已进展至终末期肾病,须依靠透析或肾脏移植维持生命,费用高,给患者和家庭造成沉重的经济负担和精神压力,已经成为全球性公共健康问题。     

北京市石景山地区中老年人群中慢性肾脏病的流行病学研究

目的 探讨我国城市中老年人群中慢性肾脏病（CKD）的患病率及危险因素。方法 对北京市石景山地区4个社区中2353名40岁以上的常住居民进行问卷调查、肾脏损伤指标及相关危险因素的检测。结果 在2310例资料完整的居民中．白蛋白尿的患病率为6．2％，肾功能下降的患病率为3．0％，血尿或非感染性白细胞尿的患病率为0．87％。该人群中CKD的患病率为9.4％。知晓率为8．3％。多因素Logistic回归提示．糖尿病及收缩压水平与白蛋白尿独立相关。高尿酸血症、白蛋白尿、年龄、高胆固醇血症及性别与肾功能下降独立相关。结论 在我国大城市中老年人群中，CKD的患病率为9。4％，接近发达国家水平；相关危险因素包括糖尿病、血压及年龄等，均与发达国家类似。     

漯河市中老年人群类风湿关节炎与慢性肾脏病流行病学调查

目的 了解漯河市中老年类风湿关节炎(RA)患者人群慢性肾脏病(CKD)流行病学现况.方法 采用分层整群抽样的的方法,抽取漯河市中老年(≥45岁)居民3266人,进行问卷调查、体格检查、肾脏损伤及RA专项检测.按结果分为RA组和非RA组.结果 3072名资料完整居民中,RA及可疑患者的患病率为6.90％,蛋白尿、血尿和eGFR下降的发生率分别为10.42％、8.59％和1.82％.与非RA组比较,RA组患者蛋白尿、eGFR下降发生率升高(分别为14.62％比10.10％,4.72％比1.61％,均P＜0.05).两组血尿发生率差异无统计学意义(10.85％比8.43％,P=0.225).本组人群中CKD的总体患病率为16.93％,RA组CKD患病率显著高于非RA组(22.17％比16.54％,P＜0.05).结论 漯河市中老年人群CKD患病率较高,RA患者人群有其特殊流行病学特征.     

120例糖尿病患者血脂血糖的监测与分析

目的 监测并分析糖尿病患者血脂血糖水平与健康人群的差异.方法 选择120例糖尿病患者进行血脂血糖监测,与同期进行健康体检的120名体检者的资料进行对比分析.结果 对照组中高脂血症发生率为20.83%,糖尿病组中高脂血症发生率为51.67%.结论 糖尿病患者群体中的高脂血症发生率显著高于健康人群.     

Epidemiological investigation on chronic kidney disease in hypertension and diabetes mellitus patients in Kunming urban community

Objective To investigate the epidemiology of chronic kidney disease (CKD) in patients with hypertension and diabetes mellitus in Kunming urban area. Methods A multistage cluster randomized sampling method was used to collect 400 randomly selected patients (community managed hypertension and diabetes mellitus) in community service centers in the 4 main urban districts of Kunming, Yunnan province. The subjects were screened for CKD by questionnaires, physical examinations, and microalbuminuria tests. Results A total of 343 people were surveyed. The prevalence of albuminuria, proteinuria by routine urinalysis, decreased glomerular filtration rate, and CKD prevalence were respectively 37.3%, 12.2%, 5.0% and 39.1%.A total of 134 patients with CKD (134/343) were screened. Logistic regression analysis showed male (OR=2.312, 95%CI 1.325-4.037, P=0.003), hyperuricemia (OR=1.751, 95%CI 1.109-2.765, P=0.016) and obesity (OR=2.150, 95%CI 1.115-4.146, P=0.022) were related to CKD. Conclusions The prevalences of CKD and albuminuria are 39.1% and 37.3% in patients with chronic diseases (hypertension and diabetes) in the main urban community of Kunming, Yunnan. Hyperuricemia, male and obesity are independent risk factors for CKD.     

Community-based screening for chronic kidney disease among populations older than 40 years in Beijing.

BACKGROUND: Chronic kidney disease (CKD) is a public health problem, while data from developing countries are limited. We sought to investigate the epidemiological features of kidney damage in metropolis-residing Chinese adults (>40 years old), and to determine the associated factors of CKD. METHODS: Two thousand three hundred and fifty-three residents in one district of Beijing were interviewed and tested for albuminuria, reduced renal function, haematuria and pyuria. The associations between demographic characteristics, health characteristics and indicators of kidney damage were examined. RESULTS: Albuminuria was detected in 6.2% of subjects; reduced renal function was found in 5.2% of subjects; haematuria was found in 0.8% and non-infective pyuria was found in 0.09%. Approximately, 11.3% (95% confidence interval: 10.0-12.8%) of subjects had at least one indicator of kidney damage. The awareness rate of CKD was only 7.2%. Systolic blood pressure and diabetes were independently associated with albuminuria. Age, diastolic blood pressure, hypercholesteraemia, hypertriglyceridaemia and hyperuricaemia were independently associated with reduced renal function. CONCLUSIONS: This is the first report on the prevalence of CKD in a community-based population within a developing country, determined using protocols recommended by kidney disease improving global outcomes (KDIGO). The prevalence of CKD in our population was close to the levels observed in developed countries, and the spectrum of CKD and associated factors were similar to developed countries. Results from this study suggest that strategies aimed at an intervention of hypertension and other metabolic disorders might prove effective in controlling the pandemic of CKD in China, as well as other developing countries.     

糖尿病肾脏病患者非透析期饮食状况的调查分析

目的调查糖尿病肾脏病患者饮食相关知识、行为及社会支持的现状及影响因素。方法调查2009年6月至2012年8月123例在广东省中医院总院及各分院内分泌科、肾病科住院及门诊就诊的非透析期2型糖尿病肾脏病患者。结果调查显示，控制饮食完全可以延缓病情进展的患者占47．2％。大多数患者认为患病后饮食中蛋白质含量应减少，但仅有一半能够正确选出含优质蛋白的食物。多数患者可以正确选择血糖指数较低的水果，但对水果食用时间并不明确。半数以上患者能明确高胆固醇食物、高脂肪食物、高钠盐食物，并限制食用，而极少数患者能每天会制定饮食计划。结论糖尿病肾脏病患者对饮食有一定认识，饮食行为尚合理，但对于饮食中蛋白质的摄入及食用水果的时间以及哪些为高胆固醇食物、高脂肪食物、高钠盐食物等问题的认识较为不足。仍有部分患者未能很好地执行糖尿病肾脏病饮食要求，因此应注意纠正患者饮食中的不良行为。