Sweileh Waleed M, Sawalha Ansam F, Zyoud Sa'ed H, Al-Jabi1 Samah W, Shraim Nasr Y
Int J Physiol Pathophysiol Pharmacol. 2009;1(1):41-47. Epub 2008 Nov 20.
Patients with diabetes mellitus and hypertension are at high risk of vascular complications, particularly, renal deterioration. This study aimed to evaluate the prevalence and the risk factors of reduced renal function corresponding to chronic kidney disease (CKD) stages 3 - 5 among diabetic hypertensive patients. This is a retrospective cohort study of diabetic hypertensive patients attending A-Watani governmental medical center from August 2006 until August 2007. Creatinine clearance (CrCl) was estimated using the Cockcroft-Gault equation. Those with CrCl< 60 ml/ min, corresponding to CDK stages 3 - 5, were considered to have reduced renal function. The prevalence of reduced renal function was calculated, and the risk factors associated with it were evaluated using multiple logistic regression. The following were the results found in this study: (a) the prevalence of reduced renal function among the study patients was 35.5% distributed as follows: (63.5%) had stage 3 CKD, 21.7% had stage 4 and 13% had stage 5 CKD. (b) Patients with reduced renal function were elderly, had a higher number of chronic diseases and had a longer duration of diabetes and hypertension than those with CrCl≥ 60ml/ min. (c) Men had a higher prevalence of reduced renal function than women. (d) Significant predictors of reduced renal function were older age, duration of diabetes and the number of chronic diseases based on logistic regression analysis. Early and continuous screening of renal function among diabetic hypertensive patients is required to implement preventable strategies of end stage renal disease (ESRD). Better control of blood pressure and diabetes mellitus are important.
糖尿病和高血压患者发生血管并发症的风险很高,尤其是肾脏功能恶化。本研究旨在评估糖尿病高血压患者中与慢性肾脏病(CKD)3 - 5期相对应的肾功能减退的患病率及危险因素。这是一项对2006年8月至2007年8月在阿瓦塔尼政府医疗中心就诊的糖尿病高血压患者进行的回顾性队列研究。使用Cockcroft - Gault方程估算肌酐清除率(CrCl)。CrCl<60 ml/分钟(对应CDK 3 - 5期)的患者被认为肾功能减退。计算肾功能减退的患病率,并使用多元逻辑回归评估与之相关的危险因素。本研究结果如下:(a)研究患者中肾功能减退的患病率为35.5%,分布如下:63.5%患有CKD 3期,21.7%患有4期,13%患有5期CKD。(b)肾功能减退的患者年龄较大,慢性病数量较多,糖尿病和高血压病程比CrCl≥60 ml/分钟的患者更长。(c)男性肾功能减退的患病率高于女性。(d)基于逻辑回归分析,肾功能减退的显著预测因素为年龄较大、糖尿病病程和慢性病数量。需要对糖尿病高血压患者进行早期和持续的肾功能筛查,以实施终末期肾病(ESRD)的可预防策略。更好地控制血压和糖尿病很重要。