Kopeć Jerzy, Januszek Rafał, Wieczorek-Surdacka Ewa, Sułowicz Władysław
Katedra i Klinika Nefrologii, Uniwersytet Jagielloński, Collegium Medicum, Kraków.
Przegl Lek. 2009;66(12):1003-10.
During the last years the incidence of chronic kidney disease (CKD) is permanently increasing and has become a global social and economical problem in the world as well as in Poland. The aim of the study was the retrospective analysis of medical records of patients with renal failure under supervision at the outpatient clinic, Department of Nephrology, University Hospital in Cracow. The study population enclosed 1183 patients (640 men and 543 women) aged between 17 and 98 years (mean 64.7) with creatinine concentration >120 micromol/l and/or creatinine clearance <90 ml/min/1.73 m2. Hemoglobin, iron, creatinine, urea, sodium, potasium, calcium, phosphate, magnesium, PTH, uric acid, albumin, total protein, bilirubin, glucose, total cholesterol, LDL and HDL cholesterol, triglicerydes concentration and values of hematocrite, MCV, HbA1, as well as alkaline phosphatase, AspAT, AIAT activity were estimated based on standard laboratory methods. Creatinine clearances were evaluated based on 3 different methods: simplified MDRD formula, Cockcroft-Gault formula and 24-h urine collection. Mean creatinine concentration in the studied population was 172.8 micromol/l (1.95 mg/dl). Hypertension was diagnosed in 65% of patients. In spite of treatment, more than half of the patients (51.9%) have increased systolic blood pressure and above 1/3 (35%) increased diastolic blood pressure. Mean hemoglobin concentration was 13.02 g/dl; more than 12% of patients had decreased hemoglobin below 11 g/dl. Mean values of parameters discovering calcium-phosphate metabolism were: calcium--2.33 mmol/l, phosphate--1.23 mmol/l and parathormon--169.3 pg/ml. Increased value of total serum cholesterol level was noted more than half of the patients (56.5%). Significant positive correlations were found between GFR calculated based on Cockcroft-Gault formula and BMI, hemoglobin, hematocrite, serum iron, diastolic blood pressure, total and LDL serum cholesterol, triglicerydes level, as well as AIAT activity and % values of HbA1c and negative with age, serum potassium, phosphorus, PTH and uric acid.
在过去几年中，慢性肾脏病（CKD）的发病率持续上升，已成为全球以及波兰的一个社会和经济问题。本研究的目的是对克拉科夫大学医院肾脏病科门诊接受监测的肾衰竭患者的病历进行回顾性分析。研究人群包括1183例患者（640例男性和543例女性），年龄在17至98岁之间（平均64.7岁），肌酐浓度>120微摩尔/升和/或肌酐清除率<90毫升/分钟/1.73平方米。根据标准实验室方法测定血红蛋白、铁、肌酐、尿素、钠、钾、钙、磷、镁、甲状旁腺激素、尿酸、白蛋白、总蛋白、胆红素、葡萄糖、总胆固醇、低密度脂蛋白和高密度脂蛋白胆固醇、甘油三酯浓度以及血细胞比容、平均红细胞体积、糖化血红蛋白的值，以及碱性磷酸酶、天冬氨酸氨基转移酶、丙氨酸氨基转移酶活性。基于3种不同方法评估肌酐清除率：简化的MDRD公式、Cockcroft - Gault公式和24小时尿收集。研究人群的平均肌酐浓度为172.8微摩尔/升（1.95毫克/分升）。65%的患者被诊断为高血压。尽管进行了治疗，但超过一半的患者（51.9%）收缩压升高，超过三分之一（35%）舒张压升高。平均血红蛋白浓度为13.02克/分升；超过12%的患者血红蛋白降低至11克/分升以下。发现钙磷代谢参数的平均值为：钙——2.33毫摩尔/升，磷——1.23毫摩尔/升，甲状旁腺激素——169.3皮克/毫升。超过一半的患者（56.5%）血清总胆固醇水平升高。基于Cockcroft - Gault公式计算的肾小球滤过率与体重指数、血红蛋白、血细胞比容、血清铁、舒张压、血清总胆固醇和低密度脂蛋白、甘油三酯水平以及丙氨酸氨基转移酶活性和糖化血红蛋白百分比值之间存在显著正相关，与年龄、血清钾、磷、甲状旁腺激素和尿酸呈负相关。
