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。

Epidemiologic study of urban adult chronic kidney disease in Youyu county of Shanxi province

Objective To investigate the prevalence of urban adult chronic kidney disease(CKD)and influential factors in Youyu county of Shanxi province in order to provide evidences for the treatment and prevention of CKD.Methods A total of 3603 residents aged ≥ 18 years old in Youyu county were selected by random cluster sampling.They were interviewed with questionnaire and tested for ulbuminuria,haematuria and renal function.Associations among demographic characteristics,health characteristies(eg.overweight or obesity,hypertension,giycometabolism abnormity)and indicators of kidney damage were examined.Results (1)Eligible data of 3502 subjects were enrolled in the study.After adjustment for age and gender,the prevalence of albuminuria,haematuria and reduced estimated glomemlar filtration rate(eGFR)was 6.8%(95%CI:6.5%-7.1%),7.1%(95%CI:6.8%-7.4%)and 2.0%(95%CI:1.8%-2.2%),respectively.Approximately 15.1%(95%C1:14.5%-15.5%)subjects had at least one indicator of kidney damage.The awareness rate of CKD was 6.9%.(2)Female had higher prevalence of albuminuria,hematuria and reduced eGFR than male(P＜0.01).(3)Albuminuria,reduced eGFR and CKD prevalence increased with age no matter male or female(P＜0.01),butoverall prevalence of hematuria was not associated with age.(4)Albuminuria was independently associated with gender,glycometabolism abnormity,hyperlipidemia,kidney disease history and the history of cardiovascular disease.Reduced eGFR was independently associated with gender,age,hypertension,glycometabolism abnormity,kidney disease history,family history of kidney disease,and microalbuminuria.Haematuria was independently associated with female.Conclusions The prevalence of adult CKD is quite high in Youyu county of Shanxi province,and the risk factors are similar to that of domestic well-developed cities and western countries.It shows a more urgent need for CKD prevention and control work in the economic underdeveloped areas.