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肾功能筛查频率与 2 型糖尿病患者肾功能下降的相关性:初级保健中的真实世界研究。

Association of renal function screening frequency with renal function decline in patients with type 2 diabetes: a real-world study in primary health care.

机构信息

Rovaniemi Health Center, Koskikatu 25, 96200, Rovaniemi, Finland.

Center for Life Course Health Research, University of Oulu, P.O Box 8000, FI-90014, Oulu, Finland.

出版信息

BMC Nephrol. 2022 Nov 4;23(1):356. doi: 10.1186/s12882-022-02979-1.

Abstract

AIMS

To examine the association of the screening frequency of estimated glomerular filtration rate (eGFR) with the substantial reduction in eGFR (≥ 25%) among type 2 diabetes (T2D) patients with normal (eGFR≥60 ml/min/1.73 m) and impaired kidney function (eGFR< 60 ml/min/1.73 m).

METHODS

A longitudinal study involving 5104 T2D patients with follow-up period of 6.8 years (1.9 SD) were treated at the Rovaniemi Health Center, Rovaniemi, Finland during 2011-2019. The association between the screening frequency of eGFR (yearly vs. non-yearly) and the substantial reduction in eGFR was studied with logistical models and adjusted with biochemical variables and preventive medications.

RESULTS

Among the T2D patients with normal kidney function, non-yearly eGFR screening was significantly associated with substantial eGFR reduction in both unadjusted (odds ratio [OR] 3.29, 95% confidence interval [CI] 2.54-4.33) and adjusted models (OR 2.06, 95% CI 1.21-3.73) compared with yearly screening frequency. In the group of patients with impaired kidney function in the unadjusted model, non-yearly eGFR screening was significantly associated with substantial eGFR reduction (OR 2.38, 95% CI 1.30-4.73), but became non-significant after adjustments (OR 1.89, 95% CI 0.61-7.21).

CONCLUSIONS

This study underscores the role of regular eGFR screening in the prevention of kidney function decline.

摘要

目的

探讨估算肾小球滤过率(eGFR)筛查频率与肾功能正常(eGFR≥60ml/min/1.73m)和肾功能受损(eGFR<60ml/min/1.73m)的 2 型糖尿病(T2D)患者 eGFR 大幅下降(≥25%)的相关性。

方法

本研究为纵向研究,纳入了 2011 年至 2019 年在芬兰罗瓦涅米健康中心接受治疗的 5104 例 T2D 患者,随访时间为 6.8 年(1.9 标准差)。使用逻辑回归模型并结合生化变量和预防用药来研究 eGFR 筛查频率(每年 vs. 非每年)与 eGFR 大幅下降之间的关系。

结果

在肾功能正常的 T2D 患者中,与每年筛查相比,非每年筛查 eGFR 与未调整(比值比[OR]3.29,95%置信区间[CI]2.54-4.33)和调整后模型(OR 2.06,95% CI 1.21-3.73)的 eGFR 显著下降显著相关。在未调整模型中,肾功能受损的患者组中,非每年 eGFR 筛查与 eGFR 显著下降显著相关(OR 2.38,95% CI 1.30-4.73),但调整后无统计学意义(OR 1.89,95% CI 0.61-7.21)。

结论

本研究强调了定期进行 eGFR 筛查在预防肾功能下降方面的作用。

相似文献

本文引用的文献

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Albuminuric and non-albuminuric patterns of chronic kidney disease in type 2 diabetes.2型糖尿病慢性肾脏病的蛋白尿和非蛋白尿模式
Diabetes Metab Syndr. 2019 Jan-Feb;13(1):474-479. doi: 10.1016/j.dsx.2018.11.014. Epub 2018 Nov 3.

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