Wu Wen-Chih, Hsieh Po-Chien, Hu Fu-Kang, Kuan Jen-Chun, Chu Chi-Ming, Sun Chien-An, Yang Tsan, Su Sui-Lung, Chou Yu-Ching
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Department of Surgery, Suao and Yuanshan branches of Taipei Veterans General Hospital, Yilan, Taiwan.
Oncotarget. 2018 Apr 13;9(28):19745-19752. doi: 10.18632/oncotarget.24820.
The high incidence and prevalence of chronic kidney disease (CKD) in Taiwan have produced tremendous burdens on health care resources. The work environment of air force special operations personnel engenders high psychological stress, and the resulting increased blood pressure can lead to glomerular hypertension and accelerated glomerular injury in the long term. The aim of the study was to establish the predictive models to define the predictors of CKD.
The results indicated that the prevalence of CKD over 4 consecutive years was 3.8%, 9.4%, 9.0%, and 9.4%. The capability of using occult blood in urine to predict the risk of CKD after 1, 2, and 3 years was statistically significant. The age-adjusted odds ratio (OR) and 95% confidence interval (CI) were 7.94 (95% CI: 2.61-24.14), 12.35 (95% CI: 4.02-37.94) and 4.25 (95% CI: 1.32-13.70), respectively.
The predictive power of occult blood in urine for the risk of CKD in each model was statistically significant. Future investigations can explore the feasibility of implementing simple and accurate urine dipsticks for preliminary testing besides annual aircrew physical examinations to facilitate early detection and treatment.
This study was a longitudinal study, in which air force special operations personnel who received physical examinations at military hospitals between 2004 and 2010 were selected. CKD was determined based on the definition provided by the US National Kidney Foundation. Overall, 212 participants that could be followed continuously for 4 years were analyzed.
台湾慢性肾脏病（CKD）的高发病率和高患病率给医疗资源带来了巨大负担。空军特种作战人员的工作环境会产生高度心理压力，长期下来由此导致的血压升高会引发肾小球高压并加速肾小球损伤。本研究的目的是建立预测模型以确定CKD的预测因素。
结果表明，连续4年的CKD患病率分别为3.8%、9.4%、9.0%和9.4%。利用尿潜血预测1年、2年和3年后CKD风险的能力具有统计学意义。年龄调整后的优势比（OR）及95%置信区间（CI）分别为7.94（95%CI：2.61 - 24.14）、12.35（95%CI：4.02 - 37.94）和4.25（95%CI：1.32 - 13.70）。
各模型中尿潜血对CKD风险的预测能力具有统计学意义。未来的研究可以探索除年度空勤人员体检外，实施简单准确的尿试纸条进行初步检测以促进早期发现和治疗的可行性。
本研究为纵向研究，选取了2004年至2010年期间在军队医院接受体检的空军特种作战人员。CKD根据美国国家肾脏基金会提供的定义确定。总共分析了212名能够连续随访4年的参与者。
