慢性肾脏病患者贫血患病现况调查

 目的 了解慢性肾脏病（chronic kidney disease，CKD）患者的贫血患病情况及其相关因素。方法 收集2007年1月至3月在复旦大学附属中山医院肾脏科门诊及住院的CKD患者的临床和实验室检查资料，调查CKD患者贫血患病率，对肾性贫血发病的危险因素进行单因素和多因素分析。结果 根据K/DOQI和我国贫血诊断标准，845例CKD患者的贫血患病率分别为69.47%和56.09%。根据K/DOQI贫血诊断标准，年龄<30岁、30~50岁、50~70岁、>70岁患者贫血患病率依次为47.83%、63.20%、71.95%、82.99%；CKD Ⅰ~Ⅴ期患者贫血患病率依次为22.00%、36.96%、45.4%、85.11%和98.29%；经eGFR矫正后，各种不同肾脏基础疾病患者的贫血患病率由高到低依次为糖尿病肾病（76.83%）、高血压肾病（67.49%）、慢性肾小球肾炎（66.05%）和多囊肾（61.45%）（P<0.05）；透析组与非透析组CKD患者的贫血患病率分别为98.24%和52.05%（P<0.001）。单因素分析表明，年龄、肾功能及透析方式均与贫血患病率相关，多因素Logistic回归分析表明仅肾功能情况与贫血患病率有显著相关性（P<0.05）。结论 慢性肾脏病患者贫血患病率高，发病早。肾功能减退、年龄等是贫血发生的危险因素。

A cross-sectional study on anemia and its risk factors in chronic kidney disease

Objective To investigate the prevalence of anemia in the patients of chronic kidney disease (CKD) and the related factors. Methods Eight hundred and forty-five patients with CKD in Zhongshan Hospital during Jan. and Mar. 2007 were enrolled. Univariate and multivariate Logistic regression analysis were carried out. Results In all of the 845 patients, the prevalence of anemia was 69.47% in K/DOQI criteria and 56.09% in Chinese criteria. According to K/DOQI criteria, the prevalences of anemia in the age ranges of <30 years, 30-50 years, 50-70 years, and >70 years were 47.83%, 63.20%, 71.95% and 82.99%, respectively; the prevalences of anemia in CKD stage Ⅰ-Ⅴ were 22%, 36.96%, 45.4%, 85.11% and 98.29%, respectively; the prevalence of anemia in CKD corrected by eGFR were associated with varied underling diseases, and the sequence from high to low was diabetic nephropathy (76.83%), hypertensive nephropathy (67.49%), chronic glomerulonephritis (66.05%) and ploycystic renal disease (61.45%)(P<0.05). The prevalence of anemia in dialysis patients and non-dialysis patients were 98.24% and 52.05% (P<0.001). Age, kidney function and dialysis modality were correlated to anemia significantly by monofactor analysis. Multivariate analysis results indicated that the kidney function was identified as an independent predictor of anemia (P<0.05). Conclusions The prevalence of anemia in chronic kidney disease patients is high even at the early stage. The kidney function and age are identified as independent predictors of anemia.