5年期间老年人群中发生的慢性肾脏病及与肾功能不全相关的新出现并发症：一项基于社区的老年人群队列研究。
Incident chronic kidney disease and newly developed complications related to renal dysfunction in an elderly population during 5 years: a community-based elderly population cohort study.
作者信息
Ahn Shin Young, Ryu Jiwon, Baek Seon Ha, Kim Sejoong, Na Ki Young, Kim Ki Woong, Chae Dong-Wan, Chin Ho Jun
机构信息
Department of Internal Medicine, Seoul National University Bundang Hopsital, Seong-Nam, Korea.
Department of Internal Medicine, Seoul National University Bundang Hopsital, Seong-Nam, Korea ; Department of Internal Mecidine, Seoul National University College of Medicine, Seoul, Korea.
出版信息
PLoS One. 2013 Dec 18;8(12):e84467. doi: 10.1371/journal.pone.0084467. eCollection 2013.
BACKGROUND
Few studies have evaluated the association between incident chronic kidney disease (CKD) and related complications, especially in elderly population. We attempted to verify the association between GFR and concurrent CKD complications and elucidate the temporal relationship between incident CKD and new CKD complications in a community-based prospective elderly cohort.
METHOD
We analyzed the available data from 984 participants in the Korean Longitudinal Study on Health and Aging. Participants were categorized into 6 groups according to eGFR at baseline examination (≥90, 75-89, 60-74, 45-59, 30-44, and <30 ml/min/1.73 m(2)).
RESULT
The mean age of study population was 76 ± 9.1 years and mean eGFR was 72.3 ± 17.0 ml/min/1.73 m(2). Compared to eGFR group 1, the odds ratio (OR) for hypertension was 2.363 (95% CI, 1.299-4.298) in group 4, 5.191 (2.074-12.995) in group 5, and 13.675 (1.611-115.806) in group 6; for anemia, 7.842 (2.265-27.153) in group 5 and 13.019 (2.920-58.047) in group 6; for acidosis, 69.580 (6.770-715.147) in group 6; and for hyperkalemia, 19.177 (1.798-204.474) in group 6. Over a 5-year observational period, CKD developed in 34 (9.6%) among 354 participants with GFR ≥ 60 ml/min/1.73 m(2) at basal examination. The estimated mean number of new complications according to analysis of co-variance was 0.52 (95% CI, 0.35-0.68) in subjects with incident CKD and 0.24 (0.19-0.29) in subjects without CKD (p = 0.002). Subjects with incident CKD had a 2.792-fold higher risk of developing new CKD complications. A GFR level of 52.4 ml/min/1.73 m(2) (p = 0.032) predicted the development of a new CKD complication with a 90% sensitivity.
CONCLUSION
In an elderly prospective cohort, CKD diagnosed by current criteria is related to an increase in the number of concurrent CKD complications and the development of new CKD complications.
背景
很少有研究评估新发慢性肾脏病（CKD）与相关并发症之间的关联，尤其是在老年人群中。我们试图在一个基于社区的前瞻性老年队列中验证肾小球滤过率（GFR）与并发的CKD并发症之间的关联，并阐明新发CKD与新的CKD并发症之间的时间关系。
方法
我们分析了韩国健康与衰老纵向研究中984名参与者的可用数据。根据基线检查时的估算肾小球滤过率（eGFR）将参与者分为6组（≥90、75 - 89、60 - 74、45 - 59、30 - 44以及<30 ml/min/1.73 m²）。
结果
研究人群的平均年龄为76 ± 9.1岁，平均eGFR为72.3 ± 17.0 ml/min/1.73 m²。与eGFR第1组相比，第4组高血压的比值比（OR）为2.363（95%置信区间[CI]，1.299 - 4.298），第5组为5.191（2.074 - 12.995），第6组为13.675（1.611 - 115.806）；贫血方面，第5组为7.842（2.265 - 27.153），第6组为13.019（2.920 - 58.047）；酸中毒方面，第6组为69.580（6.770 - 715.147）；高钾血症方面，第6组为19.177（1.798 - 204.474）。在5年的观察期内，基础检查时GFR≥60 ml/min/1.73 m²的354名参与者中有34名（9.6%）发生了CKD。根据协方差分析，新发CKD患者中新发并发症的估计平均数量为0.52（95% CI，0.35 - 0.68），无CKD患者为0.24（0.19 - 0.29）（p = 0.002）。新发CKD患者发生新的CKD并发症的风险高2.792倍。GFR水平为52.4 ml/min/1.73 m²（p = 0.032）预测新的CKD并发症发生的敏感度为90%。
结论
在一个老年前瞻性队列中，按照现行标准诊断的CKD与并发的CKD并发症数量增加以及新的CKD并发症的发生有关。
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