慢性肾脏病3~5期患者血尿酸水平及影响因素分析

    Analysis of serum uric acid in patients with chronic kidney disease on stages 3-5 and its influencing factors

      摘要
    • 摘要: 目的 研究慢性肾脏病（CKD）3~5期患者高尿酸血症（HUA）的患病率，分析CKD 3~5期患者合并HUA的相关危险因素，探讨血尿酸和肾功能的关系。方法 选取280例CKD 3~5期患者作为研究对象，收集患者临床资料，根据血尿酸水平分为高尿酸血症组和血尿酸正常组，运用SPSS 23统计软件分析CKD 3~5期患者HUA的患病率，2组之间血肌酐、尿素氮、血糖、血压、血脂、视黄醇结合蛋白、β2微球蛋白、胱抑素C等之间的差异性以及CKD 3~5期患者HUA的相关危险因素。结果 280例CKD患者中，高尿酸血症组203例，正常血尿酸组77例，HUA的总患病率为72.5%，其中CKD 3期患者HUA的患病率为61.46%，CKD 4期为74.12%，CKD 5期为81.82%。随着肾小球滤过率（eGFR）下降，HUA的患病率逐渐增高。2组患者高血压患病率的差异有统计学意义（P<0.05）。与正常血尿酸组比较，高尿酸血症组eGFR明显降低，舒张压、视黄醇结合蛋白、β2微球蛋白、胱抑素C明显增高，差异有统计学意义（P<0.05）。多元线性回归分析发现，CKD 3~5期患者的基线血尿酸水平与eGFR呈线性负相关（r=-0.277，P<0.001）。多因素Logistic回归分析显示，CKD 3~5期患者HUA的独立危险因素为合并高血压、舒张压升高、视黄醇结合蛋白和eGFR下降（P<0.05）。结论 CKD 3~5期患者HUA的患病率高，且随着eGFR下降逐渐增高。合并高血压、舒张压升高、视黄醇结合蛋白和eGFR下降均是其发生的独立危险因素。

       

      Abstract: Objective To study the prevalence and risk factors of hyperuricemia (HUA) in patients with chronic kidney disease (CKD) on stages 3-5, and explore the relationship between serum uric acid and renal function. Methods 280 patients were enrolled in this study. We collected patients' clinical data, and divided the patients into two groups according to the serum uric acid levels:hyperuricemia group and normal serum uric acid group. The prevalence of HUA in patients with CKD on stages 3-5, and the differences in serum creatinine, blood urea nitrogen, blood glucose, blood pressure, blood lipid, retinol binding protein, β2 microglobulin and cystatin C were analyzed between the two groups, and the risk factors of HUA in patients with CKD on stages 3-5 were studied by the SPSS23 software. Results There were 203 patients with hyperuricemia, and 77 patients with normal serum uric acid out of the 280 patients with CKD on stages 3-5. The prevalence of HUA in patients with CKD on stages 3-5 was 72.5%, and that in CKD 3, CKD 4 and CKD 5 was 61.46%, 74.12%, and 81.82% respectively. The prevalence of HUA was increased as the decrease of glomerular filtration rate (eGFR). The prevalence of hypertension between the two groups was significantly different (P<0.05). The eGFR in hyperuricemia group was significantly decreased, and the diastolic blood pressure, retinol binding protein, β2 microglobulin and cystatin C were significantly increased as compared with normal serum uric acid group (P<0.05). Multiple regression analysis showed that the baseline serum uric acid level was negatively correlated with eGFR in patients with CKD on stages 3-5 (r=-0.277, P<0.001). The Logistic regression analysis showed that the independent risk factors of HUA in patients with CKD on stages 3-5 were hypertension, increased diastolic blood pressure and renal function deterioration (P<0.05). Conclusions The prevalence of HUA in patients with CKD on stages 3-5 is high, and increased as the decrease of eGFR. Hypertension, increased diastolic blood pressure and renal function deterioration were independent risk factors of HUA.

       

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