慢性肾功能衰竭的基本构成: 单中心956例临床研究

目的探讨慢性肾功能衰竭（CRF）住院患者病因的基本构成，为临床诊治提供数据。方法调查我院。肾内科2009年1月至2010年12月住院患者中全部慢性肾功能衰竭患者。结果慢性肾功能衰竭患者共956例，占同期住院总人数的44．4％。其中男性527例，女性429例；城市（各级市和市属区）患者670例，乡村（县城、乡、镇、村）患者286例；CKD2期90例，CKD3期228例，CKD4期160例，CKD5期478例。慢性肾功能衰竭的年龄构成为16-89岁，平均（53．8±17．5）岁，其中青年（≤35岁）185例，中年（36-59岁）366例，老年（≥60岁）405例，首次诊断的患者691例，占72．3％，其中需要透析治疗357例，占37．3％。慢性肾功能衰竭病因构成：慢性肾炎占23．8％，糖尿病肾病占16．7％，高血压肾损害占8．2％，多囊。肾占2．5％，狼疮性肾炎占1．4％，病因不详者占32．2％。结论本组数据中，慢性肾功能衰竭来自城市患者多于乡村，中、老年人多于青年人，病因主要为慢性肾炎、糖尿病、高血压、多囊肾等。无法判断病因患者较多，首次诊断即为慢性肾功能衰竭的患者也较多。

Etiological analysis of chronic renal failure: a single center clinical study of 956 cases

Objeodve To investigate the clinical data of hospitalized patients with chronic renal failure （CRF） so as m provide basis for clinical diagnosis and treatment. Methods All hospitalized patients with CRF in Nephrology Department of China-Japan Friendship Hospital from January 2009 to December 2010 were included. Results A total of 956 patients with CRF were investigated, acmounting for 44.4% of the total hospitalized patients in the hospital. There were 527 males and 429 females; 670 cases from urban （city and municipal area） and 286 cases from countryside （county, town and village）; 90 cases of chronic kidney disease 2（CKD2）, 228 cases of CKD3, 160 cases of CKD4, and 478 cases of CKD5. Their age ranged from 16-89 years（53.8 ± 17.5） years], including 185 cases ≤35 years, 366 cases at age of 36-59 years, and 405 cases≤60 years. First diagnosis of CRF was established in 691 patients（72.3%）, among which there were 357 patients needing dialysis treatment, accounting for 37.3%. The causes of CRF included chronic glomerulonephritis （23.8%）, diabetic nephropathy （16.7%）, hypertensive renal damage （8.2%）, polyeysfic kidney disease （2.5%）, lupus nephritis （1.4%）. But, there were still 32.2% of patients with unknown cause. Conclusion There are more CRF patients from urban than from countryside. There are more middle aged or elderly CRF patients than young CRF patients. The main causes of CRF include chronic glomerulonephritis, diabetes, hypertension, polycystic kidney disease, etc. But there are still considerable number of patients without accurate cause. Near 3/4 patients get the first diagnosis of CRF.