北京大学医学部机构知识库
Advanced  
IR@PKUHSC  > 北京大学第一临床医学院  > 肾脏内科  > 期刊论文
学科主题: 肾脏病学
题名:
中晚期慢性肾脏病患者肾功能进展危险因素——单中心慢性肾脏病专业门诊队列研究
其他题名: Risk factors for progression of advanced chronic kidney disease——A monocentric cohort study from a specific CKD outpatient management clinic
作者: 孟立强; 王玉; 张路霞; 吕继成; 王海燕
关键词: 肾疾病,慢性 ; 队列研究 ; 肾功能 ; 蛋白尿 ; 贫血 ; Kidney disease, chronic ; Cohort study ; Progression ; Proteinuria ; Anemia
刊名: 中华肾脏病杂志
发表日期: 2011
DOI: 10.3760/cma.j.issn.1001-7097.2011.08.001
卷: 27, 期:8, 页:555-560
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 探讨在慢性肾脏病(CKD)专业门诊管理下CKD 3~5期未透析患者肾功能进展相关危险因素。方法 采取前瞻性队列研究设计,收集北京大学第一医院CKD专业门诊规律随访的CKD 3~5期未透析患者的血压、血红蛋白、钙磷代谢及蛋白尿等指标控制及肾功能的变化情况,进行肾功能进展的多因素分析。肾功能进展定义为每年估计的肾小球滤过率(eGFR)下降大于4ml·min-1·(1.73 m2)-1、开始肾脏替代治疗和(或)肾脏病相关的死亡。结果 共纳入138例患者,其中CKD 3期84例,4期36例,5期18例。进入队列时基线年龄为(56.5±16.7)岁,基线eGFR为(32.3±13.4) ml ·min-1(1.73 m2)-1,平均随访(27.1±12.1)个月。随访过程中患者平均血压(126.5±12.4)/(76.4±7.9) mm Hg;平均血红蛋白(123.4±17.6)g/L;平均钙磷乘积(45.2±7.7) mg2/dl2。分别有70例(50.7%)血压控制达标;102例(73.9%)血红蛋白控制达标;123例(89.1%)患者钙磷乘积控制达标;62例(44.9%)患者肾功能进展。多因素分析显示,随访过程中蛋白尿和血红蛋白水平与肾功能进展独立相关。结论通过CKD专业门诊的一体化治疗,能够有效控制中晚期CKD患者的各种并发症。控制蛋白尿和(或)改善贫血有利于延缓中晚期CKD患者肾功能进展。 Objective To identify the risk factors for progression of advanced chronic kidney disease (CKD) patients who were cared by nephrologists in a specific CKD outpatient management clinic.Methods A prospective monocentric cohort study was performed.CKD patients of stage 3, 4 and 5 without renal replacement treatment were followed up regularly by nephrologists in this specific CKD management clinic.Patients with established atherosclerotic renal artery stenosis (ARAS) and chronic tubulointerstitial nephritis, and those who had not been followed-up for at least 12 months before Jun.30, 2010 were excluded.Clinical and laboratory data including blood pressure (BP), proteinuria, hemoglobulin (Hb), calcium phosphate product (Ca×P) and serum creatinine were consecutively collected.The treatment regimen was also recorded.Estimated glomerular filtration rate (eGFR) was calculated with the formula modified for Chinese to evaluate the change of renal function.The progression of kidney disease was defined as initiation of renal replacement therapy, the annual decrease of eGFR>4 ml·min-1·(1.73 m2)-1, and/or death associated with renal disease. Results A total of 138 patients were enrolled in the final analysis with 84 patients of CKD stage 3, 36 of CKD stage 4 and 18 of CKD stage 5, respectively.At the time of enrollment, patients had an average age of (56.5:±:16.7) years old with an average eGFR of (32.3±13.4) ml·min-1·(1.73 m2)-1.During a mean follow-up interval of (27.1±12.1) months, the patients were well-controlled with an average blood pressure of (126.5±12.4)/(76.4±7.9) mm Hg in 50.7%(70/138), less than or equal to 130/80 mm Hg, an average Hb of (123.8±17.1) g/L in 73.9%(102/138), above or equal to 110 g/L and an average Ca×P of (45.2±7.7) mg2/dl2 in 89.1%(123/138), less than or equal to 55 mg2/dl2.Sixty-two patients (44.9%) had progression of kidney disease. On univariate analysis, factors predicting progression were low eGFR at referral, high systolic pressure, low Hb level, high Ca×P and proteinuria during follow-up, and renin-angiotensin system inhibitors treatment did not affect the progression.After the adjustment, multivariate analysis revealed proteinuria and low Hb level were independent factors for the progression of kidney disease. Conclusions The co-morbidities of advanced CKD patients can be managed efficiently in specific CKD outpatient management clinic.Control of proteinuria and correction of anemia may be beneficial to prevent the progression of advanced CKD.
语种: 中文
原文出处: 查看原文
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/45943
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

Files in This Item:

There are no files associated with this item.


作者单位: 100034,北京大学第一医院肾内科北京大学肾脏病研究所卫生部肾脏疾病重点实验室

Recommended Citation:
孟立强,王玉,张路霞,等. 中晚期慢性肾脏病患者肾功能进展危险因素——单中心慢性肾脏病专业门诊队列研究[J]. 中华肾脏病杂志,2011,27(8):555-560.
Service
Recommend this item
Sava as my favorate item
Show this item's statistics
Export Endnote File
Google Scholar
Similar articles in Google Scholar
[孟立强]'s Articles
[王玉]'s Articles
[张路霞]'s Articles
CSDL cross search
Similar articles in CSDL Cross Search
[孟立强]‘s Articles
[王玉]‘s Articles
[张路霞]‘s Articles
Related Copyright Policies
Null
Social Bookmarking
Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit
所有评论 (0)
暂无评论
 
评注功能仅针对注册用户开放,请您登录
您对该条目有什么异议,请填写以下表单,管理员会尽快联系您。
内 容:
Email:  *
单位:
验证码:   刷新
您在IR的使用过程中有什么好的想法或者建议可以反馈给我们。
标 题:
 *
内 容:
Email:  *
验证码:   刷新

Items in IR are protected by copyright, with all rights reserved, unless otherwise indicated.

 

 

Valid XHTML 1.0!
Copyright © 2007-2017  北京大学医学部 - Feedback
Powered by CSpace