The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
The Department of Advanced Cardiology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
J Nephrol. 2019 Oct;32(5):775-781. doi: 10.1007/s40620-019-00605-2. Epub 2019 Apr 6.
Risk factors for renal function deterioration in the general population are not fully understood. We aimed to clarify the determinants of estimated glomerular filtration rate (eGFR) decline using a community-based cohort.
Among 3217 subjects who underwent repeated health check-ups, we excluded 478 subjects with eGFR ≤ 60 mL/min/1.73 m and examined 2739 subjects. EGFR decline rate was calculated from the difference in eGFR between the first and last visits. EGFR decline, which was defined as a drop in GFR accompanied by a 25% or greater drop in eGFR from baseline and/or a sustained decline of more than 5 mL/min/1.73 m/year, was observed in 209 subjects (7.6%). Anemia according to the WHO definition (16.7% vs. 11.7%, p = 0.03), and proteinuria (3.3% vs. 0.8%, p < 0.001) at baseline were more commonly observed in subjects with eGFR decline. Multivariable logistic regression analysis showed that anemia and proteinuria were independently associated with eGFR decline.
Anemia and proteinuria were closely related to eGFR decline, which suggests that we should consider these parameters as risk factors of the development of renal function deterioration even in the general population.
目前尚不完全清楚一般人群肾功能恶化的危险因素。我们旨在使用基于社区的队列来阐明估算肾小球滤过率（eGFR）下降的决定因素。
在接受了重复健康检查的 3217 名受试者中，我们排除了 eGFR≤60 mL/min/1.73 m 的 478 名受试者，并检查了 2739 名受试者。eGFR 下降率是通过第一次和最后一次就诊之间的 eGFR 差异计算得出的。观察到 209 名受试者（7.6％）出现 eGFR 下降，其定义为 GFR 下降伴有 eGFR 从基线下降 25％或以上和/或持续下降超过 5 mL/min/1.73 m/年。在基线时，根据世界卫生组织（WHO）定义，贫血（16.7％比 11.7％，p = 0.03）和蛋白尿（3.3％比 0.8％，p <0.001）更为常见。多变量逻辑回归分析表明，贫血和蛋白尿与 eGFR 下降独立相关。
贫血和蛋白尿与 eGFR 下降密切相关，这表明我们即使在一般人群中，也应将这些参数视为肾功能恶化发展的危险因素。
