慢性肾脏病病因构成及变化趋势分析  

Analysis of etiological composition and changing trend of chronic kidney disease

作　　者：吴宇 周晶晶 姜世敏 张铮[3] 卓莉[3] 李文歌[3] Wu Yu;Zhou Jingjing;Jiang Shimin;Zhang Zheng;Zhuo Li;Li Wenge(Department of Nephrology,China-Japan Friendship Hospital,Beijing University of Chinese Medicine Medical College Beijing 100029,China;Department of Nephrology,China-Japan Friendship Hospital,Capital Medical University Medical College,Beijing 100029,China;Department of Nephrology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学临床医学院中日友好医院肾病科,北京100029 [2]首都医科大学中日友好临床医学院肾病科,北京100029 [3]中日友好医院肾病科,北京100029

出　　处：《中华健康管理学杂志》2021年第5期442-445,共4页Chinese Journal of Health Management

基　　金：北京市科技计划(D171100002817003);中国健康促进基金会项目(2018-2022)。

摘　　要：目的分析慢性肾脏病(CKD)病因构成及变化趋势。方法对中日友好医院1990—1991年173例、2009—2010年956例及2018—2019年1440例CKD住院患者病因进行总结,分析3个时间段中青年组与老年组CKD的病因构成和演变。利用χ^(2)检验进行组间比较,两两比较应用Bonferroni法校正。结果1990—1991年、2009—2010年和2018—2019年CKD的第一位病因分别为慢性肾炎(52%)、慢性肾炎(35%)和糖尿病(36%)。3个时间段的CKD病因构成有显著差异(χ^(2)=74.375,P<0.001),其中糖尿病(χ^(2)=14.847,P=0.001)和高血压(χ^(2)=12.279,P=0.002)导致的CKD占比呈上升趋势,慢性肾炎(χ^(2)=19.976,P<0.001)占比呈下降趋势。老年组中,3个时间段CKD的第一位病因分别为慢性肾炎(34%)、糖尿病(40%)和糖尿病(43%)。中青年组3个时间段中,慢性肾炎始终是CKD的第一位病因,占比分别为49%,43%和40%,呈下降趋势,但差异无统计学意义。糖尿病(χ^(2)=31.345,P<0.001)和高血压(χ^(2)=15.485,P<0.001)在中青年CKD患者中均呈上升趋势。在2018—2019年队列中,终末期肾脏病(ESRD)有494例,糖尿病和高血压在ESRD中的占比分别为48%和37%。结论糖尿病和高血压是老年CKD的主要病因。慢性肾炎仍是中青年CKD的主要病因,但占比呈下降趋势。糖尿病和高血压也是引起ESRD的主要病因。Objective To analyze the etiological composition and changing trends in chronic kidney disease.Methods CKD patients from our hospital were in cluded in the study from three separate periods,173 patients from 1990-1991,956 patients from 2009-2010,and 1440 patients from 2018-2019.The etiology of CKD in patients between the younger and middle-aged group and the elderly group were compared using theχ^(2)test,and the Bonferroni method was used to correct the pairwise comparisons.Results The leading cause of CKD in 1990-1991,2009-2010,and 2018-2019 was chronic glomerulonephritis(52%),chronic glomerulonephritis(35%),and diabetes(36%),respectively.The distribution of the etiologies was different signficantly among the three cohorts(χ^(2)=74.375,P<0.001).Compared with 1990-1991,the percentage of CKD related to diabetes(χ^(2)=14.847,P=0.001)and hypertension(χ^(2)=12.279,P=0.002)significantly increased,while chronic glomerulonephritis showed a downward trend(χ^(2)=19.976,P<0.001).Among the elderly CKD patients,the leading cause of CKD in the three cohorts was chronic glomerulonephritis(34%),diabetes(40%),and diabetes(43%),respectively.Conversely,diabetes and hypertension have become the predominant causes in 2009-2010 and 2018-2019.Although chronic glomerulonephritis remained the leading cause of CKD in the past 30 years,the percentage declined gradually among the younger and middle-aged patients with CKD.The percentage of CKD related to diabetes(χ^(2)=31.345,P<0.001)and hypertension(χ^(2)=15.485,P<0.001)significantly increased.In addition,in the 2018-2019 cohort,there were 494 patients with end-stage renal disease(ESRD),and the percentage of ESRD related to diabetes and hypertension were 48%and 37%,respectively.Conclusion Diabetes and hypertension have become the predominant causes of CKD in Chinese elderly patients.Although chronic glomerulonephritis was the leading cause among the younger and middle-aged patients with CKD,the percentage declined gradually.Additionally,diabetes and hypertension were also the predom

关 键 词：慢性肾脏病 糖尿病 高血压 慢性肾炎 老年 

分 类 号：R692[医药卫生—泌尿科学]