北京市平谷区普通人群高钾血症患病率及影响因素  

Prevalence of hyperkalemia and influencing factors in a rural population in Pinggu district of Beijing city

作　　者：樊晓红[1] 叶文玲[1] 马杰[1] 孙颖[1] 崔锐[1] 张薇[1] 王宝宝[1] 李雪梅[1] Fan Xiaohong;Ye Wenling;Ma Jie;Sun Ying;Cui Rui;Zhang Wei;Wang Baobao;Li Xuemei(Chinese Academy of Medical Sciences,Department of Nephrology,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院肾内科,北京100730

出　　处：《中华肾脏病杂志》2022年第4期289-295,共7页Chinese Journal of Nephrology

基　　金：国家十二五科技支撑计划(2012BAJ18B03);北京协和医学院研究生教育教学改革项目(10023201800101)。

摘　　要：目的探讨北京市平谷区普通人群中高钾血症(hyperkalemia,HK)的患病率及HK发生的影响因素。方法本研究为横断面调查研究,研究对象来自2014年3月至2014年5月北京市平谷区慢性病流行病学调查人群,所有研究对象均面访行问卷调查,人体学指标测量,血液标本留取用于测定血肌酐、血钾等临床指标,留取首次晨尿标本测定白蛋白肌酐比值等。HK定义为血钾>5.0 mmol/L,低钾血症定义为血钾≤3.5 mmol/L。采用Logistic回归分析法分析HK的影响因素。结果共纳入研究对象10252名,HK患病率为6.17%(95%CI 5.70%~6.67%),其中血钾>5.5 mmol/L的患病率为0.53%(95%CI 0.40%~0.69%),低钾血症患病率为0.61%(95%CI 0.47%~0.79%)。多因素Logistic回归分析结果显示男性(OR=1.269,95%CI 1.074~1.498,P=0.005)、糖尿病(OR=1.226,95%CI 1.008~1.490,P=0.041)、总胆固醇升高(OR=1.219,95%CI 1.119~1.329,P<0.001)及估算肾小球滤过率下降(OR=0.971,95%CI 0.965~0.977,P<0.001)与发生HK风险独立相关,未发现使用肾素-血管紧张素-醛固酮系统抑制剂和利尿剂与HK发生风险显著相关(OR=1.018,95%CI 0.751~1.380,P=0.908;OR=0.638,95%CI 0.229~1.781,P=0.391)。结论本研究发现普通人群中HK的患病率为6.17%,男性、估算肾小球滤过率下降、合并糖尿病、总胆固醇升高为HK发生的影响因素。Objective To determine the epidemiology of hyperkalemia and influencing factors in a general population in Pinggu district of Beijing city.Methods This study was a cross-sectional survey.The subjects were from the epidemiological survey population of chronic diseases in Pinggu district of Beijing city from March to May 2014.All participants completed a questionnaire,anthropological measurement,and venous blood samples collection to detect serum creatinine and potassium and so on.First void morning urine was collected to detect the albumin-creatinine ratio.Hyperkalemia and hypokalemia were defined as serum potassium level>5.0 mmol/L and≤3.5 mmol/L,respectively.Logistic regression analysis method was used to analyze the influencing factors of hyperkalemia.Results Of the 10252 people in this study,the prevalence of hyperkalemia was 6.17%(95%CI 5.70%-6.67%),the prevalence of hypokalemia was 0.61%(95%CI 0.47%-0.79%),and the prevalence of participants with serum potassium>5.5 mmol/L was 0.53%(95%CI 0.40%-0.69%).Multivariate logistic regression analysis results showed that males(OR=1.269,95%CI 1.074-1.498,P=0.005),diabetes(OR=1.226,95%CI 1.008-1.490,P=0.041),increased total cholesterol(OR=1.219,95%CI 1.119-1.329,P<0.001),and decreased estimated glomerular filtration rate(OR=0.971,95%CI 0.965-0.977,P<0.001)were significantly correlated with the increased risk of hyperkalemia.Usage of renin-angiotensin-aldosterone system inhibitors and diuretics were not found to be significantly associated with the risk of hyperkalemia(OR=1.018,95%CI 0.751-1.380,P=0.908;OR=0.638,95%CI 0.229-1.781,P=0.391).Conclusions The prevalence of HK in the general population is 6.17%.The male,decreased estimated glomerular filtration rate,diabetes,and increased total cholesterol are influencing factors of hyperkalemia.

关 键 词：高钾血症 患病率 危险因素 流行病学方法 

分 类 号：R589.4[医药卫生—内分泌]