老年人血尿酸水平与肾小球滤过率及慢性肾病的相关性分析  

Correlation of serum uric acid level with estimated glomerular filtration rate and chronic kidney disease in the elderly

作　　者：吴玉颜 林丽珠 刘蝶梅 陈嘉瑜 黎春婷 柯渠青 WU Yuyan;LIN Lizhu;LIU Diemei;CHEN Jiayu;LI Chunting;KE Quqing(Department of Health Management,the Seventh Affiliated Hospital of Southern Medical University,Foshan 528000,China)

机构地区：[1]南方医科大学第七附属医院健康管理科,广东省佛山市528000

出　　处：《实用老年医学》2025年第3期272-277,共6页Practical Geriatrics

基　　金：佛山市医学科研立项课题(20220298)。

摘　　要：目的探讨老年人群血尿酸水平(serum uric acid,SUA)与估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)下降及慢性肾脏病(chronic kidney disease,CKD)发生发展的关系。方法构建佛山地区老年人群队列,选取2021年1-12月在南方医科大学第七附属医院体检的65岁及以上老年人群作为研究对象,通过问卷调查、体格检查、血脂、血糖、肝肾功能等实验室检查收集基线资料。2022年1月1日至2023年12月31日间,每年体检时进行随访,共随访2年。采用多元线性回归分析SUA水平与eGFR及eGFR斜率的相关性。以病人CKD分期是否进展作为结局指标,构建logistic回归模型,分析不同尿酸水平与CKD发生发展的关系。结果随着SUA水平升高,eGFR显著下降(P<0.001),CKD患病率显著上升(P<0.001)。基线SUA与eGFR斜率及CKD的进展无相关性(P>0.05),随访2年间SUA变化水平与eGFR斜率及CKD的进展呈显著相关性(P<0.001)。Logistic回归分析显示,SUA变化水平是CKD分期进展的危险因素。结论老年人群SUA与eGFR及CKD的患病率显著相关,SUA的变化水平与eGFR下降及CKD的进展显著相关,控制SUA水平变化可以更好地预防CKD的发生发展。Objective To explore the relationship of serum uric acid(SUA)level with the decline in estimated glomerular filtration rate(eGFR)and the progression of chronic kidney disease(CKD)among the elderly.Methods A cohort of elderly adults in Foshan was established.The elderly individuals aged≥65 years old who underwent health examinations in the Seventh Affiliated Hospital of Southern Medical University from January to December 2021 were enrolled in this study.The basic data of questionnaires,physical examinations,and laboratory indicators including blood lipids,blood glucose,and liver and kidney function were collected.All cases were followed for 2 years.The correlations of SUA level with eGFR and eGFR slope were analyzed by multiple linear regression analysis.Logistic regression model was used to investigate the influencing factors of the progression of CKD stage.Results With the increase of SUA level,eGFR significantly decreased(P<0.001),and the prevalence of CKD significantly increased(P<0.001).There was no statistical correlation between baseline SUA level and eGFR slope or CKD progression during the 2-year follow-up(P>0.05),but there was a significant correlation between the change of SUA level and eGFR slope or CKD progression(P<0.001).Logistic regression analysis showed that the change of SUA level was the risk factor for CKD progression.Conclusions In the elderly adults,SUA is significantly correlated with eGFR and the prevalence of CKD.The change of SUA level is significantly correlated with the decline of eGFR and the progression of CKD.Controlling the change of SUA level can prevent the occurrence and development of CKD.

关 键 词：血尿酸 肾小球滤过率 慢性肾病 队列研究 

分 类 号：R692[医药卫生—泌尿科学]