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动脉高血压患者慢性肾脏病发生的相关因素

Factors Associated with the Development of Chronic Kidney Disease in Patients with Arterial Hypertension.

作者信息

Goicochea-Rios Evelyn Del Socorro, Chian-García Ana María, Yupari-Azabache Irma Luz, Gómez Goicochea Néstor Iván

机构信息

School of Medicine, Universidad César Vallejo, Trujillo, Peru.

出版信息

Int J Nephrol Renovasc Dis. 2024 Mar 29;17:113-123. doi: 10.2147/IJNRD.S448986. eCollection 2024.

Abstract

INTRODUCTION

Chronic kidney disease affects a large part of the population with hypertension, diabetes mellitus as well as those over 50 years of age. Research reported that male sex and other comorbidities such as obesity and anemia are more frequent in Chronic kidney disease, as well as uncontrolled diabetes mellitus or hypertension.

OBJECTIVE

To determine the risk factors associated with the development of chronic kidney disease in adults with arterial hypertension.

MATERIAL AND METHODS

Retrospective cohort study of 455 patients with hypertension treated in a primary health care hospital. Medical records and laboratory information were reviewed for the diagnosis of chronic kidney disease and its staging. Patients aged 40 years and older, of both sexes and evaluated between the years 2015 -2017 were included. Logistic regression analysis allowed the identification of risk factors associated with the development of chronic kidney disease.

RESULTS

63.7% were female and 36.3% male. The average age for 2015 was 69.79 ± 9.03, more than half of participants had diabetes mellitus and controlled hypertension and the predominant nephroprotection was with Losartan (53%) that year. Male sex (OR 1.68, CI 1.03-2,76), age: 60 years or older (OR 6.38, CI 2.65-15,37) and anemia (OR 1.71, CI 1.03-2,85), were risk factors for the development of chronic kidney disease (p < 0.05), whereas nephroprotection (OR 0.39, CI 0.18-0,88) and controlled diabetes mellitus (OR: 0.18, CI 0.07-0,47) were shown to be protective factors (p < 0.05). The prevalence of chronic kidney disease between 2015 and 2017 was 19% and 45%, respectively, with predominance of category G2. The comparison group is the same cohort analyzed in each year under study.

CONCLUSION

Male sex, age over 60 years, and anemia are risk factors for chronic kidney disease. Nephroprotection, controlled diabetes mellitus, and patient follow-up are factors that prevent its development.

摘要

引言

慢性肾脏病影响着很大一部分患有高血压、糖尿病的人群以及50岁以上的人群。研究报告称,男性以及肥胖和贫血等其他合并症在慢性肾脏病患者中更为常见,同时还存在未得到控制的糖尿病或高血压。

目的

确定患有动脉高血压的成年人发生慢性肾脏病的相关危险因素。

材料与方法

对一家初级保健医院治疗的455例高血压患者进行回顾性队列研究。查阅病历和实验室信息以诊断慢性肾脏病及其分期。纳入年龄在40岁及以上、性别不限且在2015年至2017年期间接受评估的患者。通过逻辑回归分析确定与慢性肾脏病发生相关的危险因素。

结果

女性占63.7%,男性占36.3%。2015年的平均年龄为69.79±9.03岁,超过半数的参与者患有糖尿病且高血压得到控制,当年主要的肾脏保护药物是氯沙坦(53%)。男性(比值比1.68,95%置信区间1.03 - 2.76)、年龄60岁及以上(比值比6.38,95%置信区间2.65 - 15.37)和贫血(比值比1.71,95%置信区间1.03 - 2.85)是慢性肾脏病发生的危险因素(p<0.05),而肾脏保护(比值比0.39,95%置信区间0.18 - 0.88)和控制良好的糖尿病(比值比0.18,95%置信区间0.07 - 0.47)被证明是保护因素(p<0.05)。2015年至2017年期间慢性肾脏病的患病率分别为19%和45%,以G2期为主。对照组为每年所研究的同一队列。

结论

男性、60岁以上年龄和贫血是慢性肾脏病的危险因素。肾脏保护、控制良好的糖尿病以及患者随访是预防其发生的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f48/10986410/d95bd8a204d3/IJNRD-17-113-g0001.jpg

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