Ⅲ-V期慢性肾病患者贫血的危险因素分析

目的调查Ⅲ～V期慢性肾病（cKD）患者贫血的发生率及相关危险因素。方法随机选择我院2010年2月至2013年2月诊断为慢性肾脏病并肾小豫滤过率低于60ml／min患者218例，分析患者临床资料及其与贫血发生的相关性。结果Ⅲ～V期慢性肾病患者中贫血发生率分别为49．2％、82．9％和95．6％。透析患者的贫血发生率（95．9％）较非透析患者（66．9％）高，差异有统计学意义（P〈0．05）。单因素分析显示年龄、CKD分期、是否透析、白蛋白及血钙水平、体重指数、尿渗透浓度、N-乙酰—β-D-氨基葡萄糖苷酶（NAG）、血清EPO水平与贫血的发生率有关（P〈0．05）；多因素Logistic回归分析显示仅CKD分期、白蛋白及血钙水平与贫血的发生显著相关（P〈0．05）。结论CKD分期晚、白蛋白及血钙水平低是Ⅲ～V期慢性肾病患者发生贫血的相关危险因素。

Analysis of risk factors for anemia in patients with phase III to V chronic kidney disease.

Objective To investigate the prevalence and risk factors of anemia in the patients with phase Ⅲto V chronic kidney disease （CKD）. Methods 218 patients diagnosed as CKD with glomerular filtration rate 〈 60ml/ rain were collected in our hospital from February 2010 to February 2013. The association between clinical data and anemia occurrence was analysed. Results The prevalenees of anemia in patients with phase Ⅲ-V CKD were 49.2%, 82.9% and 95.6%, respectively. The prevalence of anemia in dialysis patients and non-dialysis patients were 95.9% and 66.9% （P〈0.05）. Univariate analysis indicated that age, CKD phase, dialysis, albumin and blood calcium levels, body mass index, urine osmotic concentration, N-acetyl-β-D-glucosaminidase （NAG） and serum erythropoie- tin （EPO） levels were related to the occurrence of anemia （P〈0.05）. Multivariate logistic regression analysis indicated that only CKD phase, albumin and calcium levels were significantly related with anemia （P〈0.05）. Conclusions Ad- vanced CKD phase, low albumin and calcium levels were risk factors of anemia in patients with phase Ⅲ-VCKD.