肾小球滤过率与肾脏替代治疗启动的相关性研究  

Correlation between glomerular filtration rate and initiation of renal replacement therapy

作　　者：刘伟俊 吴锡信 LIU Wei-jun;WU Xi-xin(Graduate School,Guangdong Medical University,Zhanjiang 524023,Guangdong,CHINA;Department of Nephrology,the Second People's Hospital of Guangdong Province,Guangzhou 510317,Guangdong,CHINA)

机构地区：[1]广东医科大学研究生院,广东湛江524023 [2]广东省第二人民医院肾内科,广东广州510317

出　　处：《海南医学》2020年第15期1930-1935,共6页Hainan Medical Journal

基　　金：广东省佛山市医学科技计划项目(编号:2015AB000642)。

摘　　要：目的探讨慢性肾脏病(CKD)3~4期患者的初始实测肾小球滤过率(mGFR)与2年内进展至肾脏替代治疗(RRT)的相关性。方法收集153例2012年1月至2018年1月期间在广东省第二人民医院肾内科就诊并检测99mTc-DTPA清除率评估肾小球滤过率(GFR)为CKD 3~4期患者的临床资料。通过多元回归调整原发肾脏病、高血压病、糖尿病、尿蛋白、血红蛋白、肌酐、尿素氮、β2微球蛋白(β2M)、胱抑素C、白蛋白等混杂因素,评估初始mGFR与2年RRT启动的独立相关性。结果初始mGFR与2年RRT启动风险呈显著负相关(HR=0.71,95%CI为0.52~0.98,P=0.039),即在调整其他混杂因素后,初始mGFR每下降5 mL/(min·1.73 m2),CKD患者2年RRT启动风险将增加29%。结论初始mGFR能为CKD 3~4期患者2年RRT启动风险提供重要信息。Objective To investigate the correlation between the initial measured glomerular filtration rate(mGFR)and the progression to renal replacement therapy(RRT)within two years in patients with chronic kidney disease(CKD)at 3-4 stages.Methods The clinical data of 153 patients,who admitted to Department of Nephrology,the Second People's Hospital of Guangdong Province from January 2012 to January 2018,were collected.The glomerular filtration rate(GFR)of these patients as CKD 3-4 were evaluated by detecting 99mTc DTPA clearance rate.Multiple regression was used to adjust the confounding factors of primary kidney disease,hypertension,diabetes mellitus,urinary protein,hemoglobin,creatinine,urea nitrogen,β2-microglobulin(β2M),Cystatin C and albumin,to evaluate the independent correlation between initial mGFR and 2-year RRT initiation.Results There was a significant negative correlation between initial mGFR and 2-year RRT initiation(HR=0.71,95%CI=0.52 to 0.98,P=0.039).After adjusting for other confounding factors,for every 5 mL/(min·1.73 m2)decrease in initial mGFR,the risk of RRT initiation in CKD patients will increase by 29%in two years.Conclusion The initial mGFR can provide important information for the risk of RRT initiation in CKD 3-4 patients.

关 键 词：慢性肾脏病 肾小球滤过率 肾脏替代治疗 相关性 进展 风险评估 多重插补 

分 类 号：R692[医药卫生—泌尿科学]