Qingping Li, Ribao Wei, Yang Wang, Tingyu Su, Xi Yang, Mengjie Huang, Hui Miao, Xiangmei Chen
Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China (mainland).
Med Sci Monit. 2017 Apr 23;23:1956-1962. doi: 10.12659/msm.904374.
BACKGROUND The aim of this study was to analyze changes in kidney function and its correlation with nutritional metabolism indicators in hospitalized elderly patients in a large medical center over the past 7 years. MATERIAL AND METHODS The renal function of patients over 60 years old in the Chinese PLA General Hospital in 2008, 2011, and 2014 were comparatively analyzed. The hemoglobin, serum albumin, triglycerides, cholesterol, uric acid, and urea nitrogen data were collected and used as the nutritional metabolism indicators. In addition, the correlation between these indicators and the eGFR was analyzed. RESULTS The numbers of patients who received kidney function assessments in the 3 years were 15 752, 23 539, and 49 828; their mean ages were 69.97±6.99, 69.51±7.11, and 69.45±7.74 years. The median values of serum creatinine were 75.4, 76.5, and 77.5 μmol/L in the men and 59.6, 60.7, and 62.1 μmol/L in the women. The eGFR in both sexes demonstrated a gradual decreasing trend over the 3 years. According to the CKD staging method, analysis of the different percentages of eGFR intervals in the patients showed that the percentages of the 3 groups with an eGFR lower than 60 mL/min/1.73 m² exhibited a rising trend annually. Correlational analysis of the nutritional indicators showed that the correlations between Hb, ALB, TG, TC, Ur, and BUN with an eGFR lower than 60 mL/min/1.73 m² were 0.582, 0.780, 1.219, 1.364, 2.180, and 3.677, respectively. CONCLUSIONS Serum creatinine showed a gradually increasing trend over the 3 study years. The CKD-EPI equation calculation results showed that the eGFR in elderly people of both sexes gradually decreased. Reduction of hemoglobin and albumin was a risk factor for decreased kidney function, while increases in uric acid and blood lipids affected the progression of renal insufficiency.
背景 本研究旨在分析过去7年中一家大型医疗中心住院老年患者的肾功能变化及其与营养代谢指标的相关性。材料与方法 对2008年、2011年和2014年中国人民解放军总医院60岁以上患者的肾功能进行了比较分析。收集血红蛋白、血清白蛋白、甘油三酯、胆固醇、尿酸和尿素氮数据作为营养代谢指标。此外,分析了这些指标与估算肾小球滤过率(eGFR)之间的相关性。结果 3年中接受肾功能评估的患者人数分别为15752、23539和49828;他们的平均年龄分别为69.97±6.99岁、69.51±7.11岁和69.45±7.74岁。男性血清肌酐的中位数分别为75.4、76.5和77.5μmol/L,女性为59.6、60.7和62.1μmol/L。在这3年中,男女的eGFR均呈逐渐下降趋势。根据慢性肾脏病(CKD)分期方法,对患者不同eGFR区间的百分比进行分析,结果显示eGFR低于60 mL/min/1.73 m²的3组患者的百分比呈逐年上升趋势。营养指标的相关性分析表明,血红蛋白(Hb)、白蛋白(ALB)、甘油三酯(TG)、胆固醇(TC)、尿酸(Ur)和尿素氮(BUN)与eGFR低于60 mL/min/1.73 m²之间的相关性分别为0.582、0.780、1.219、1.364、2.180和3.677。结论 在3年的研究期间,血清肌酐呈逐渐上升趋势。CKD-EPI方程计算结果显示,老年男女的eGFR逐渐下降。血红蛋白和白蛋白降低是肾功能下降的危险因素,而尿酸和血脂升高影响肾功能不全的进展。