慢性肾病患者酸碱紊乱的回顾性研究

L.D. Denova, D. Ivanov
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They were divided into 2 groups: group 1 (n = 31) — stage 1–3 CKD and group 2 (n = 22) — stage 4–5 CKD. An analysis of ABS indicators was carried out in dyna­mics. Results. Results of multiple linear regression for patients with stage 1–5 CKD (n = 53) showed that there was a strong significant effect between potassium (K+) and glomerular filtration rate (GFR) (F(1, 13) = 10.59, p = 0.006, R2 = 0.45, R2 adj = 0.41). The results of multiple linear regression of indicators in patients with stage 1–3 CKD (group 1) demonstrated a weak insignificant influence between lactate and GFR (F(1, 15) = 1.11, p = 0.310, R2 = 0.07, R2 adj = 0.01). 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摘要

背景。肾功能受损会对人体的酸碱状态(ABS)产生负面影响。然而,酸碱状态失常会加重慢性肾脏病(CKD)的病情。因此,在对 CKD 患者进行检查和治疗时,有必要考虑到 ABS。研究目的:对在基辅一家医疗机构门诊就医的 1-5 期 CKD 患者的 ABS 指标动态进行回顾性分析。材料和方法。对 2022 年 2 月至 2023 年 2 月期间在 Dmytro Ivanov 肾病诊所有限责任公司门诊就医并诊断为 1-5 期慢性肾脏病的 53 名患者(表 025/o)的病历进行了回顾性、随机、队列研究。参与者接受了三次 ABS 指标检查。他们被分为两组:第一组(31 人)--1-3 期慢性肾功能衰竭;第二组(22 人)--4-5 期慢性肾功能衰竭。对 ABS 指标进行动态分析。结果如下对 1-5 期 CKD 患者(n = 53)的多元线性回归结果显示,钾(K+)与肾小球滤过率(GFR)之间存在强烈的显著影响(F(1, 13) = 10.59, p = 0.006, R2 = 0.45, R2 adj = 0.41)。1-3 期 CKD 患者(第 1 组)指标的多元线性回归结果显示,乳酸与 GFR 之间的影响微弱不显著(F(1,15)= 1.11,P=0.310,R2=0.07,R2 adj=0.01)。对 4-5 期 CKD 患者(第 2 组)的指标进行多元线性回归的结果显示,氢指数、二氧化碳分压、氧分压、碳酸氢盐浓度、细胞外液碱过量、K+、二氧化碳总量、阴离子间隙(K 浓度包含在方程中)、碱过量、乳酸与 GFR 之间存在极强的合并不显著影响(F(10,-3)= 0.3,p = 58.099,R2 = -65.23,R2 adj = 155.53)。结论在研究 1-5 期慢性肾脏病患者的 ABS 时,使用多元线性回归工具发现 K+ 和 GFR 之间存在相关性。在第一组中,乳酸与 GFR 之间存在关系;在第二组中,所有预测因子均与 GFR 存在关系。
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Retrospective study of acid-base disturbances in patients with chronic kidney disease
Background. Impaired kidney function has a negative effect on the body’s acid-base status (ABS). However, a violation of ABS can worsen the course of chronic kidney disease (CKD). Therefore, during the examination and treatment of patients with CKD, it is necessary to take into account the ABS. The purpose of the study: to conduct a retrospective analysis of the dynamics of ABS indicators in patients with stage 1–5 CKD who sought outpatient medical care in a medical institution in Kyiv. Materials and methods. A retrospective, randomized, cohort study was performed of 53 medical records of patients (form 025/o) who sought outpatient medical care at the Professor Dmytro Ivanov Nephrological Clinic LLC with a diagnosis of stage 1–5 CKD from February 2022 to February 2023. Participants were examined for ABS indicators three times. They were divided into 2 groups: group 1 (n = 31) — stage 1–3 CKD and group 2 (n = 22) — stage 4–5 CKD. An analysis of ABS indicators was carried out in dyna­mics. Results. Results of multiple linear regression for patients with stage 1–5 CKD (n = 53) showed that there was a strong significant effect between potassium (K+) and glomerular filtration rate (GFR) (F(1, 13) = 10.59, p = 0.006, R2 = 0.45, R2 adj = 0.41). The results of multiple linear regression of indicators in patients with stage 1–3 CKD (group 1) demonstrated a weak insignificant influence between lactate and GFR (F(1, 15) = 1.11, p = 0.310, R2 = 0.07, R2 adj = 0.01). The results of multiple linear regression of indicators in patients with stage 4–5 CKD (group 2) showed that there is a very strong combined insignificant influence between the hydrogen index, partial pressure of carbon dioxide, partial pressure of oxygen, bicarbonate concentration, base excess of extracellular fluid, K+, total carbon dioxide, anion gap with K concentration included in the equation, base excess, lactate and GFR (F(10, –3) = 0.3, p = 58.099, R2 = –65.23, R2 adj = 155.53). Conclusions. When studying ABS in patients with stage 1–5 CKD, a correlation was found between K+ and GFR using the multiple linear regression tool. In the first group, the relationship between lactate and GFR, in the second one, all predictors had a relationship with GFR.
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