单中心慢性肾脏病3～5期患者肾性贫血的相关因素分析

目的 评估慢性肾脏病（CKD）3～5期患者肾性贫血（RA）情况，探讨影响CKD 3～5期患者RA的危险因素，评估血红蛋白与实验室指标的相关性。方法 选取2019年6月—2021年5月在青海省人民医院肾内科住院治疗的CKD 3～5期患者282例。收集患者人口学特征及临床资料，根据RA诊断标准将患者分为RA组（176例）与非RA组（106例）。比较两组性别、年龄、基础疾病、生化检查、海拔等因素，分析RA与海拔、患者一般资料、生化指标的关系。结果 RA组女性占比、BUN、Scr、IPTH、LH、PRL、Hepc水平高于非RA组（P <0.05），RBC、SI、TIBC、TSAT、T、EPO、HIF水平低于非RA组（P <0.05）。多因素逐步Logistic回归分析结果表明，BUN ［O^R=1.413（95% CI：1.026，1.947）］、Scr ［O^R=1.079（95% CI：1.008，1.154）］、Hepc ［O^R=1.104（95% CI：1.029，1.185）］是CKD 3～5期患者发生RA的危险因素；RBC ［O^R=0.560（95% CI：0.394，0.796）］、SI ［O^R=0.627（95% CI：0.457，0.861）］、EPO ［O^R=0.652（95% CI：0.506，0.839）］、HIF ［O^R=0.943（95% CI：0.914，0.972）］是CKD 3～5期患者发生RA的保护因素（P <0.05）。CKD 3～5期患者HGB水平与BUN、Scr、Hepc呈负相关（r =-0.304、-0.488、-0.405、-0.404、-0.297、-0.256、-0.195、-0.232和-0.312，均P <0.05），与RBC、SI、EPO、HIF呈正相关（r =0.967、0.224、0.183、0.266、0.253和0.151，P <0.05）。结论 EPO、HIF、RBC、SI、BUN、Scr、Hepc是CKD 3～5期患者RA的影响因素。

Predictive factors for renal anemia among patients with stage 3 to 5 chronic kidney disease in a single center

Objective To evaluate the condition of renal anemia (RA) in patients with stage 3 to 5 chronic kidney disease (CKD), to explore the risk factors for RA in patients with stage 3 to 5 CKD, and to evaluate the correlation between hemoglobin and laboratory indicators.Methods We included 282 patents with stage 3 to 5 CKD admitted to our hospital from June 2019 to May 2021. Demographic characteristics and clinical data of patients were recorded. Patients were divided into RA group (176 cases) and non-RA group (106 cases) according to the diagnostic criteria of RA. The sex composition, age, underlying diseases, biochemical indicators, and altitude of residence were compared between the two groups, and the correlations of RA with altitude of residence, general characteristics of patients and laboratory indicators were analyzed.Results The proportion of females and levels of BUN, Scr, IPTH, LH, PRL and Hepc in RA group were higher than those in non-RA group, while RBC count, levels of SI, T, EPO and HIF, TIBC, and TSAT in RA group were lower than those in non-RA group (P < 0.05). Multivariable Logistic regression analysis showed that high levels of BUN [O^R = 1.413 (95% CI: 1.026, 1.947) ], Scr [O^R = 1.079 (95% CI: 1.008, 1.154) ] and Hepc [O^R = 1.104 (95% CI: 1.029, 1.185) ] were risk factors for RA in patients with stage 3 to 5 CKD, and that high RBC count [O^R = 0.560 (95% CI: 0.394, 0.796) ], and levels of SI [O^R =0.627 (95% CI: 0.457, 0.861) ], EPO [O^R = 0.652 (95% CI: 0.506, 0.839) ] and HIF [O^R = 0.943 (95% CI: 0.914, 0.972) ] were protective factors for RA in patients with stage 3 to 5 CKD (P < 0.05). Correlation analysis demonstrated that the level of HGB was negatively correlated with levels of BUN, Scr and Hepc (r = -0.304, -0.488, -0.405, -0.404, -0.297, -0.256, -0.195, -0.232 and -0.312, all P < 0.05 ) and positively correlated with RBC count, and levels of SI, EPO and HIF in patients with stage 3 to 5 CKD (r = 0.967, 0.224, 0.183, 0.266, 0.253 and 0.151, all P < 0.05).Conclusions EPO, HIF, RBC, SI, BUN, Scr and Hepc are all predictors for RA in patients with stage 3 to 5 CKD.