Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong.
Nephrology (Carlton). 2017 Dec;22 Suppl 4:35-42. doi: 10.1111/nep.13148.
Family members of patients with end-stage renal disease (ESRD) have higher risk for chronic kidney disease (CKD). Limited study has examined the risk of developing CKD in relatives of patients in earlier stages of CKD.
From January 2008 to June 2009, the Hong Kong Society of Nephrology studied first-degree relatives of stage 1-5 CKD patients from 11 local hospitals. A total of 844 relatives of 466 index CKD patients (stages 1-2: 29.6%; stage 3: 16.7%; stage 4: 10.9%; stage 5: 42.7%) were reviewed for various risk factors of CKD. We also defined a composite marker of kidney damage by the presence of one or more following features: (i) positive urine protein, (ii) spot urine protein-to-creatinine ratio ≥0.15 mg/mg, (iii) hypertension and (iv) estimated glomerular filtration rate (eGFR) ≤60 mL/min per 1.73 m and determine its association with participant and index patient factors.
Among these 844 relatives, 23.1%, 25.9% and 4.4% of them had proteinuria (urine protein ≥1+), haematuria (urine red blood cell ≥1+) and glycosuria (urine glucose ≥1+), respectively. Proteinuria (P = 0.10) or glycosuria (P = 0.43), however, was not associated with stages of CKD of index patients. Smoking participants had a significantly lower eGFR (102.7 vs. 107.1 mL/min per 1.73 m ) and a higher prevalence of proteinuria (33.6% vs. 21.4%). Multivariate analysis showed that older age, male gender, obesity, being parents of index patients and being the relatives of a female index patient were independently associated with a positive composite marker.
First-degree relatives of all stages of CKD are at risk of developing CKD and deserve screening. Parents, the elderly, obese and male relatives were more likely to develop markers of kidney damage.
患有终末期肾病（ESRD）的患者的家属患慢性肾脏病（CKD）的风险较高。很少有研究检查过处于 CKD 早期阶段的患者的亲属患 CKD 的风险。
2008 年 1 月至 2009 年 6 月，香港肾脏病学会研究了来自 11 家当地医院的 1-5 期 CKD 患者的一级亲属。对 466 名 CKD 指数患者（1-2 期：29.6%；3 期：16.7%；4 期：10.9%；5 期：42.7%）的 844 名亲属进行了各种 CKD 危险因素的检查。我们还通过以下一种或多种特征的存在来定义肾脏损伤的复合标志物：（i）尿蛋白阳性，（ii）尿蛋白/肌酐比值（spot urine protein-to-creatinine ratio）≥0.15mg/mg，（iii）高血压和（iv）估计肾小球滤过率（eGFR）≤60mL/min/1.73m，并确定其与参与者和指数患者因素的关系。
在这 844 名亲属中，分别有 23.1%、25.9%和 4.4%的人出现蛋白尿（尿蛋白≥1+）、血尿（尿红细胞≥1+）和糖尿（尿葡萄糖≥1+）。然而，蛋白尿（P=0.10）或糖尿（P=0.43）与指数患者的 CKD 阶段无关。吸烟的参与者的 eGFR（102.7 比 107.1mL/min/1.73m）明显较低，蛋白尿的发生率（33.6%比 21.4%）较高。多变量分析显示，年龄较大、男性、肥胖、是指数患者的父母以及是女性指数患者的亲属，与复合标志物阳性独立相关。
所有 CKD 阶段的一级亲属都有患 CKD 的风险，需要进行筛查。父母、老年人、肥胖和男性亲属更有可能出现肾脏损伤的标志物。
