Risk factors for chronic kidney disease in a community-based population: a 10-year follow-up study
Risk factors for chronic kidney disease in a community-based population: a 10-year follow-up study
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DOI：
10.1038/sj.ki.5002017
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发表时间：
2007-01-01
影响因子：
19.6
通讯作者：
Koyama, A.
中科院分区：
文献类型：
--
作者：
Yamagata, K.;Ishida, K.;Koyama, A.
本研究旨在探讨影响普通人群慢性肾脏病（CKD）发病率的危险因素。我们对123 764名（男性：41 012人，女性：82 752人）40岁及以上的成年人进行了为期10年的随访研究，这些人接受了以社区为基础的年度检查。分析的主要结局是随访期间CKD的发展。通过考克斯回归模型中的显著性风险比（HR），按性别获得CKD发生的预测因素。随访期间，4307例受试者（男性：2048例，女性：2259例）发生CKD I期或II期，19411例受试者（男性：4257例，女性：15154例）发生CKD III期或更高期。基线校正的CKD发生的预测因素包括年龄、肾小球滤过率、血尿、高血压、糖尿病、血脂、肥胖、吸烟和饮酒。在男性受试者中治疗的糖尿病，以及在女性受试者中治疗的高血压、收缩压> 160 mm Hg和/或舒张压> 100 mm Hg、糖尿病和治疗的糖尿病与HR的两倍以上相关。而蛋白尿和血尿与男性受试者的HR增加一倍以上有关。成人中10年内新发CKD的患病率为23718例受试者（19.2%）。提示高血压、糖尿病及多种代谢异常是CKD的独立危险因素。
The purpose of this study was to explore risk factors affecting the incidence of chronic kidney disease (CKD) in general population. We conducted a 10-year follow-up study with 123 764 (male: 41 012, female: 82 752) adults aged 40 years and over who received community-based annual examinations. The primary outcome for the analysis was the development of CKD during the follow-up period. Predictors for the development of CKD were obtained by the significant hazard ratios (HR) in Cox regression model by sex. During the follow-up period, 4307 subjects (male: 2048, female: 2259) developed CKD stage I or II, and 19 411 subjects (male: 4257, female: 15 154) developed CKD stage III or higher. The baseline-adjusted predictor of developing CKD included age, glomerular filtration rate, hematuria, hypertension, diabetes, serum lipids, obesity, smoking status, and consumption of alcohol. Treated diabetes in male subjects, and treated hypertension, systolic blood pressure > 160 mm Hg and/or diastolic blood pressure > 100mm Hg, diabetes, and treated diabetes in female subjects were associated with more than a doubling of the HR. For the development of CKD stage III or higher, proteinuria of >=++, and proteinuria and hematuria were associated with more than a doubling of the HR in male subjects. The prevalence of newly developed CKD over 10 years was 23 718 subjects (19.2%) in adults. This study suggested that not only hypertension and diabetes but also several metabolic abnormalities were independent risk factors for developing CKD.