慢性肾脏病患者尿电解质相关临床因素分析
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江苏省自然科学基金(BK20191075);中华医学会临床医学专项资金?施维雅肾脏病青年研究与发展项目(17010090678)


The evaluation of urinary electrolyte excretion in patients with chronic kidney disease
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    目的:分析慢性肾脏病(chronic kidney disease,CKD)非透析患者24 h尿电解质排泄特点及其与临床因素的关联性。方法:选取2017年5月—2019年4月住院CKD患者752例,回顾性分析24 h尿电解质与临床指标的关系。结果:尿钠、尿钾排泄在CKD 1~4期无统计学差异(P>0.05),尿钙、尿磷排泄随肾小球滤过率下降呈下降趋势(P<0.05)。无论CKD患者有无高血压、糖尿病等合并症,尿钠、尿钾与尿蛋白呈正相关,尿钙与尿蛋白呈负相关(P<0.05),尿磷与尿蛋白无相关性(P>0.05)。低尿磷组高血压及心血管疾病的患病率高于高尿磷组,低尿钙组心血管疾病的患病率高于高尿钙组,高尿钾组糖尿病的患病率高于低尿钾组(P<0.05)。结论:CKD患者尿电解质水平与尿蛋白、糖尿病、高血压及心血管疾病等合并症的患病率存在关联,其管理应受到更多重视。

    Abstract:

    Objective:To investigate the characteristics of 24-hour urinary electrolyte excretion in non-dialysis patients with chronic kidney disease(CKD)and its correlation with clinical parameters. Methods:A total of 752 patients with CKD from May 2017 to April 2019 were selected to retrospectively analyze the relationship between 24-hour urinary electrolytes and clinical indicators. Results:Our results showed that there was no significant difference in urinary sodium or urinary potassium excretion in patients with different stages of CKD1-4. However,urinary calcium and urinary phosphorus excretion decreased with the decline of glomerular filtration rate. Besides,24-hour urinary sodium and urinary potassium were positively correlated with 24-hour urine protein,regardless of the complication of high blood pressure or diabetes. Meanwhile,24-hour urinary calcium was negatively correlated with 24-hour urine protein and 24-hour urinary phosphorus was showed no correlation with 24-hour urine protein. The prevalence of hypertension and cardiovascular disease in the low urine phosphorus group was higher than that in the high urine phosphorus group,the prevalence of cardiovascular disease in the low urine calcium group was higher than that in the high urine calcium group,and the prevalence of diabetes in the high urine potassium group was higher than that in the low urine potassium group. Conclusion:The level of urine electrolyte in patients with CKD is associated with urine protein,the prevalence of hypertension,diabetes and cardiovascular diseases. Its management deserves more attention.

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孙连芹,聂广燕,左晨艳,袁杨刚,张承宁,毛慧娟,邢昌赢,张 波,段俗言.慢性肾脏病患者尿电解质相关临床因素分析[J].南京医科大学学报(自然科学版),2020,(8):1163-1169

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  • 收稿日期:2019-11-08
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  • 在线发布日期: 2020-08-21
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