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慢性肾病患者的估计肾小球滤过率、尿白蛋白尿肌酐比值与中风患病率之间的关联。

Association between estimated glomerular filtration rate, urinary albuminuria-creatinine ratio, and stroke prevalence in patients with chronic kidney disease.

作者信息

Xiang Jianfeng, Tong Mengli, Yu Dongrong, Chen Yinfeng

机构信息

Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

Ren Fail. 2025 Dec;47(1):2452219. doi: 10.1080/0886022X.2025.2452219. Epub 2025 Jan 27.

Abstract

BACKGROUND

With the global increase in chronic diseases, chronic kidney disease (CKD) and stroke have become major public health concerns. This study aims to investigate the relationship between estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), and the incidence of stroke in a CKD population.

METHODS

This cross-sectional study analyzed the relationship between eGFR, UACR, and prevalence of self-reported stroke in 6,037 participants using data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. Multivariate logistic regression analysis was used to evaluate the association of eGFR, UACR with the incidence of stroke, and smoothing curve fitting was applied to explore the linear relationship between eGFR and stroke. To further explore the effect of eGFR on stroke risk, we performed subgroup analyses of demographic factors.

RESULTS

After adjusting for confounding factors, eGFR was found to be significantly negatively associated with stroke risk. Compared with participants with an eGFR ≥ 90 mL/min/1.73 m, the risk of stroke was increased in those with an eGFR of 60-90 (OR = 1.78; 95% CI = 1.18-2.69), 30-60 (OR = 2.26; 95% CI = 1.49-3.44), and <30 mL/min/1.73 m (OR = 3.14; 95% CI = 1.74-5.65). In the unadjusted model, patients with UACR of 30-300 mg/g had a slightly lower risk of stroke than those with UACR < 30 mg/g (OR = 0.70, 95% CI = 0.57-0.86); however, this association was not seen after adjusting for potential confounders.

CONCLUSIONS

This study identified a negative linear correlation between eGFR and stroke in CKD patients.

摘要

背景

随着全球慢性病数量的增加,慢性肾脏病(CKD)和中风已成为主要的公共卫生问题。本研究旨在调查慢性肾脏病患者中估算肾小球滤过率(eGFR)、尿白蛋白与肌酐比值(UACR)与中风发病率之间的关系。

方法

这项横断面研究利用2007年至2018年美国国家健康与营养检查调查(NHANES)的数据,分析了6037名参与者的eGFR、UACR与自我报告的中风患病率之间的关系。采用多因素逻辑回归分析评估eGFR、UACR与中风发病率的关联,并应用平滑曲线拟合探索eGFR与中风之间的线性关系。为进一步探讨eGFR对中风风险的影响,我们对人口统计学因素进行了亚组分析。

结果

在调整混杂因素后,发现eGFR与中风风险呈显著负相关。与eGFR≥90 mL/min/1.73 m²的参与者相比,eGFR为60 - 90(OR = 1.78;95%CI = 1.18 - 2.69)、30 - 60(OR = 2.26;95%CI = 1.49 - 3.44)和<30 mL/min/1.73 m²(OR = 3.14;95%CI = 1.74 - 5.65)的参与者中风风险增加。在未调整模型中,UACR为30 - 300 mg/g的患者中风风险略低于UACR<30 mg/g的患者(OR = 0.70,95%CI = 0.57 - 0.86);然而,在调整潜在混杂因素后,这种关联未被观察到。

结论

本研究确定了慢性肾脏病患者中eGFR与中风之间存在负线性相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee3f/11774156/e5a26c3e28d1/IRNF_A_2452219_UF0001_C.jpg

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