中国全科医学2017，Vol.20Issue(22)：2739-2745,7.DOI:10.3969/j.issn.1007-9572.2017.22.011
慢性肾脏病患者24 h尿蛋白定量与贫血的关系研究
Association between 24-hour Urinary Protein Level and Anemia in CKD Patients
摘要
Abstract
Objective To evaluate the association between 24-hour urinary protein level and anemia in chronic kidney disease(CKD) patients.Methods Eight hundred and sixty-six CKD inpatients who received treatment in Department of Nephrology,Renmin Hospital of Wuhan University from October 2015 to October 2016 were enrolled.Based on the 24-hour urinary protein level,they were divided into three groups:group A1(24-hour urinary protein level≤1.0 g),group A2(1.0 g<24-hour urinary protein level≤3.0 g),group A3(24-hour urinary protein level>3.0 g).The diagnosis of anemia was based on hemoglobin(Hb).CKD stage was determined by eGFR.Spearman′s rank correlation analysis was performed to find the association between 24-hour urinary protein level and Hb.Univariate Logistic regression analysis and multivariate Logistic regression analysis were performed to determine the factors which have associations with anemia.ORs for anemia stratified by the joint distribution of 24-hour urinary protein level and CKD stage were calculated,when groups CKD 1 and A1 as the reference groups.Results Of the participants,there were 325(37.5%) with anemia.Hb level and incidence of anemia differed significantly between the groups(P<0.05),while anemia type did not(P>0.05).Spearman′s rank correlation analysis demonstrated that 24-hour urinary protein level was negatively correlated with Hb level(P<0.05).Univariate Logistic regression analysis showed that sex,age,systolic blood pressure and primary disease,CKD stage,treatment with ACEI/ARB agents,hypertension prevalence,diabetes prevalence,cardiovascular disease prevalence,serum albumin,calcium,phosphorus,transferrin saturation,ferritin,folic acid,vitamin B12(VitB12),and 24-hour urinary protein level were associated factors for anemia in CKD patients(P<0.05).Multivariate Logistic regression analysis showed that sex,age,primary disease,CKD stage,serum calcium,transferrin saturation,ferritin,folic acid,VitB12,and 24-hour urinary protein level were significantly associated with anemia in CKD patients or non-diabetic nephropathy patients(P<0.05).Increased ORs were observed in joint-distributed groups with higher 24-hour urinary protein level and CKD stage compared with the reference groups A1 and CKD 1(ORs were 1.437~59.108).Conclusion The present study showed that the 24-hour urinary protein level was independently associated with anemia in patients with CKD,and increased urinary protein level indicated higher risk of anemia.关键词
肾疾病/贫血/蛋白尿Key words
Kidney diseases/Anemia/Proteinuria分类
医药卫生引用本文复制引用
熊扬眉,丁国华,石明,陈星华..慢性肾脏病患者24 h尿蛋白定量与贫血的关系研究[J].中国全科医学,2017,20(22):2739-2745,7.基金项目
国家自然科学基金资助项目(81570617、81500516) （81570617、81500516）
