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2 型糖尿病患者慢性肾脏病的患病率及相关危险因素:初级保健实践中的横断面研究。

Prevalence and Risk Factors of Chronic Kidney Disease among Type 2 Diabetes Patients: A Cross-Sectional Study in Primary Care Practice.

机构信息

Kidney Center, Sansai Hospital, Chiang Mai, 50290, Thailand.

Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.

出版信息

Sci Rep. 2020 Apr 10;10(1):6205. doi: 10.1038/s41598-020-63443-4.

Abstract

This cross-sectional study aimed to investigate the prevalence and risk factors of chronic kidney disease (CKD) among 1,096 primary care type 2 diabetes (T2DM) patients in northern Thailand between October 2016 and September 2017. CKD was defined as estimated glomerular rate filtration values of <60 mL/min/1.73 m. Prevalence with confidence intervals across CKD advanced stages 3-5 were estimated. Factors associated with CKD were evaluated by multivariate logistic regression. The overall prevalence of CKD was 24.4% (21.9-27.0), with severities of 11.4% (9.7-13.4), 6.8% (5.5-8.5), 4.6% (3.5-6.0), and 1.6% (1.0-2.5) for stages 3 A, 3B, 4, and 5, respectively. Regarding age and glycaemic control, individuals older than 75 years and those with a haemoglobin A1c ≥ 8% had the highest prevalence of 61.3% (51.7-70.1) and 38.6% (34.3-43.2), respectively. The multivariable logistic regression model explained 87.3% of the probability of CKD. The six independent significant risk factors of CKD were older age, retinopathy, albuminuria, haemoglobin A1c ≥ 7%, anaemia, and uric acid>7.5 mg/dL. A relatively high prevalence of CKD, especially in older patients and those with diabetic complications-related to poor glycaemic control, was encountered in this primary care practice. Early identification may help to target optimise care and prevention programs for CKD among T2DM patients.

摘要

本横断面研究旨在调查 2016 年 10 月至 2017 年 9 月期间泰国北部 1096 例初级保健 2 型糖尿病(T2DM)患者中慢性肾脏病(CKD)的患病率和危险因素。CKD 的定义为估算肾小球滤过率<60ml/min/1.73m。估计了 CKD 各期(3-5 期)的患病率及置信区间。采用多元逻辑回归分析评估与 CKD 相关的因素。CKD 的总患病率为 24.4%(21.9-27.0),其中 3A、3B、4 和 5 期的严重程度分别为 11.4%(9.7-13.4)、6.8%(5.5-8.5)、4.6%(3.5-6.0)和 1.6%(1.0-2.5)。就年龄和血糖控制而言,年龄大于 75 岁和糖化血红蛋白 A1c≥8%的患者患病率最高,分别为 61.3%(51.7-70.1)和 38.6%(34.3-43.2)。多变量逻辑回归模型解释了 CKD 概率的 87.3%。6 个独立的 CKD 危险因素为年龄较大、视网膜病变、白蛋白尿、糖化血红蛋白 A1c≥7%、贫血和尿酸>7.5mg/dL。在这种初级保健实践中,CKD 的患病率相对较高,尤其是在老年患者和与血糖控制不佳相关的糖尿病并发症患者中。早期发现可能有助于针对 T2DM 患者的 CKD 进行优化护理和预防计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e21f/7148316/c689eefb7787/41598_2020_63443_Fig1_HTML.jpg

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