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[2型糖尿病患者人群中隐匿性慢性肾脏病的患病率及相关变量]

[Prevalence of occult chronic kidney disease and associated variables in a population of patients with type 2 diabetes].

作者信息

Rodríguez-Poncelas Antonio, Quesada Sabate Miquel, Coll De Tuero Gabriel, Caula Ros Jacint, Gelada-Batlle Esther, Gómez-Marcos Manuel Angel, Garre-Olmo Josep, García-Ortiz Luis, Comalada Daniel Carme, Ramos Blanes Rafel

机构信息

Area Bàsica de Salut d'Anglès, Institut d'Assistència Sanitària de Girona, Girona, España.

出版信息

Med Clin (Barc). 2010 Mar 6;134(6):239-45. doi: 10.1016/j.medcli.2009.06.069. Epub 2010 Jan 6.

Abstract

BACKGROUND AND OBJECTIVE

To determine the prevalence of occult chronic kidney disease (CKD) and the associated clinical variables in patients with type 2 diabetes mellitus (DM-2).

PATIENTS AND METHOD

Observational, laboratory and cross-sectional study of patients with DM-2 from primary care settings. Demographic and anthropometric data, previous illnesses and measures of cardiovascular risk and kidney function were collected from electronic medical records. We determined the prevalence of occult CKD defined as patients with normal values of plasma creatinine (Cr) and reduced glomerular filtration rate (GFr) (< 60 ml/min/1,73 m(2)). The GFr was determined by the Modification of Diet in Renal Disease (MDRD) equation.

RESULTS

The sample consisted of 3,197 patients, the mean age was 67.7 years (SD = 11.7) and 53.9% were men. The prevalence of CKD according to the MDMR values was 16.6% (n = 532), of which 60.3% (n = 321) corresponded to occult CKD. 6.6% (n = 211) of the participants had CKD with high Cr values. Multivariate analysis showed an association of occult CKD with female sex (OR = 2.7; CI 95% = 1,83-3,99). Occult CKD was associated with age, blood pressure higher than 150/100 mm/Hg and with a history of ischemic heart disease, heart failure, peripheral arterial disease and dyslipemia.

CONCLUSIONS

The prevalence of CKD is 16.6%, of which 60.3% (n = 321) corresponds to occult CKD. Female sex is associated with the presence of occult CKD.

摘要

背景与目的

确定2型糖尿病(DM-2)患者中隐匿性慢性肾脏病(CKD)的患病率及相关临床变量。

患者与方法

对基层医疗单位的DM-2患者进行观察性、实验室及横断面研究。从电子病历中收集人口统计学和人体测量数据、既往疾病以及心血管风险和肾功能指标。我们将隐匿性CKD定义为血浆肌酐(Cr)值正常但肾小球滤过率(GFr)降低(<60 ml/min/1.73 m²)的患者,并据此确定其患病率。GFr通过肾脏病饮食改良(MDRD)方程计算得出。

结果

样本包括3197例患者,平均年龄为67.7岁(标准差=11.7),男性占53.9%。根据MDMR值,CKD的患病率为16.6%(n = 532),其中60.3%(n = 321)为隐匿性CKD。6.6%(n = 211)的参与者患有Cr值升高的CKD。多因素分析显示隐匿性CKD与女性性别相关(比值比=2.7;95%置信区间=1.83 - 3.99)。隐匿性CKD与年龄、血压高于150/100 mmHg以及缺血性心脏病、心力衰竭、外周动脉疾病和血脂异常病史相关。

结论

CKD的患病率为16.6%,其中60.3%(n = 321)为隐匿性CKD。女性性别与隐匿性CKD的存在相关。

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