Hsiao Po-Jen, Liao Chen-Yi, Kao Yung-Hsi, Chan Jenq-Shyong, Lin Yuh-Feng, Chuu Chih-Pin, Chen Jin-Shuen
Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei.
Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taiwan.
Medicine (Baltimore). 2020 Jan;99(2):e18709. doi: 10.1097/MD.0000000000018709.
Kidney handling of electrolytes varies in different stages of chronic kidney disease (CKD). Diabetes mellitus (DM) plays an important role in CKD. Fractional excretion (FE) is an important means in clinical practice. The relationship between FE of electrolytes in patients at different stages of CKD is worth further investigating.We designed a cross-sectional study in 1 teaching hospital, consecutive CKD patients were enrolled between February 2016 and January 2017. Including clinical demographic features, laboratory examination including spot urine electrolytes, blood biochemistries, and relevant medications were determined.A total of 762 CKD patients completed the study. Of these, 218 (28.6%) had DM. Participants were grouped according to estimated glomerular filtration rate into 7 categories: hyperfiltration (HF), CKD1, CKD2, CKD3a, CKD3b, CKD4, and CKD5. Groups HF, CKD1, 2, 3a, 3b, 4 and 5 contained 83, 143, 192, 94, 82, 82, and 86 patients, respectively. FE of electrolytes tended to increase along with the decline of renal function (CKD1-CKD5) (P < .001). The relationship was similar between the DM and non-DM groups. Diabetic patients demonstrated higher FE of magnesium compared with non-DM subjects at CKD2 and CKD5 (P < .05).CKD patients showed a progressive increase in the FE of electrolytes; FE of magnesium seemed to increase more among diabetic patients with CKD, and could be a potential predictor of CKD progression.
慢性肾脏病（CKD）不同阶段肾脏对电解质的处理方式有所不同。糖尿病（DM）在CKD中起着重要作用。分数排泄（FE）是临床实践中的一项重要手段。CKD不同阶段患者电解质FE之间的关系值得进一步研究。
我们在1家教学医院开展了一项横断面研究，于2016年2月至2017年1月纳入连续的CKD患者。测定了包括临床人口统计学特征、实验室检查（包括随机尿电解质、血液生化指标）以及相关用药情况。
共有762例CKD患者完成了研究。其中，218例（28.6%）患有DM。参与者根据估计肾小球滤过率分为7类：高滤过（HF）、CKD1、CKD2、CKD3a、CKD3b、CKD4和CKD5。HF组、CKD1组、2组、3a组、3b组、4组和5组分别包含83例、143例、192例、94例、82例、82例和86例患者。电解质的FE往往随着肾功能下降（CKD1 - CKD5）而增加（P < 0.001）。DM组和非DM组之间的关系相似。在CKD2和CKD5阶段，糖尿病患者的镁FE高于非DM受试者（P < 0.05）。
CKD患者的电解质FE呈逐渐增加趋势；CKD糖尿病患者的镁FE似乎增加得更多，可能是CKD进展的一个潜在预测指标。
