Kwon Hanna, Lee Dong-Gi, Kang Hee Cheol, Lee Jun Ho
Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea.
Int Urol Nephrol. 2016 Apr;48(4):451-6. doi: 10.1007/s11255-016-1215-1. Epub 2016 Jan 25.
To investigate the incidence of isolated hematuria and its relationship to the glomerular filtration rate (GFR).
Data from the Korean National Health and Nutrition Examination Survey V were used. A stratified, three-stage, clustered probability design was used to collect representative data on the Korean population. Ultimately, 18,587 participants were included. The incidence of isolated dipstick hematuria and its relationship with the GFR (estimated by the Chronic Kidney Disease Epidemiology Collaboration equation) were evaluated.
The analysis showed that 31.8% of the population had isolated hematuria, the incidence of which significantly increased with age (P trend < 0.001). As the severity of hematuria increased, the ratio of GFR < 60 ml/min/1.73 m(2) and 60 ml/min/1.73 m(2) ≤ GFR < 90 ml/min/1.73 m(2) was significantly increased (P trend < 0.001). After adjusting for the confounders, the mean GFR of the grade 3+ (grades 3, 4, 5) hematuria group was significantly reduced compared to that of the negative, grade 1, and grade 2 hematuria groups (with an adjusted mean ± standard error of 94.0 ± 0.8 vs. 97.2 ± 0.3 ml/min/1.73 m(2), P < 0.001). Additionally, the odds ratio of the grade 3+ hematuria group for a GFR < 60 ml/min/1.73 m(2) was significantly increased compared to that of the negative, grade 1, and grade 2 hematuria groups after adjusting for the confounders (adjusted odds ratio 1.468, 95% confidence interval 1.049-2.054, P = 0.025).
An effective health policy for hematuria screening is needed for older age groups. A strategy of careful checkups and counseling regarding renal function is necessary for patients with isolated hematuria.
研究孤立性血尿的发生率及其与肾小球滤过率(GFR)的关系。
使用韩国国民健康与营养检查调查V的数据。采用分层、三阶段、整群概率设计来收集韩国人群的代表性数据。最终纳入18587名参与者。评估孤立性试纸法血尿的发生率及其与GFR(由慢性肾脏病流行病学协作组方程估算)的关系。
分析显示,31.8%的人群存在孤立性血尿,其发生率随年龄显著增加(P趋势<0.001)。随着血尿严重程度的增加,GFR<60 ml/min/1.73 m²和60 ml/min/1.73 m²≤GFR<90 ml/min/1.73 m²的比例显著增加(P趋势<0.001)。在调整混杂因素后,3+级(3级、4级、5级)血尿组的平均GFR与阴性、1级和2级血尿组相比显著降低(调整后均值±标准误为94.0±0.8 vs. 97.2±0.3 ml/min/1.73 m²,P<0.001)。此外,在调整混杂因素后,3+级血尿组GFR<60 ml/min/1.73 m²的比值比与阴性、1级和2级血尿组相比显著增加(调整后比值比1.468,95%置信区间1.049 - 2.054,P = 0.025)。
需要针对老年人群制定有效的血尿筛查健康政策。对于孤立性血尿患者,有必要采取仔细检查和肾功能咨询的策略。