动脉高血压患者发展为慢性肾病的相关因素

Evelyn Goicochea-Rios, Ana Chian-García, I. Yupari-Azabache, Néstor I Gómez Goicochea
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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. 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摘要

导言 慢性肾脏病影响着大部分患有高血压、糖尿病以及 50 岁以上的人群。研究报告显示,慢性肾脏病患者中,男性和肥胖、贫血等其他合并症以及未得到控制的糖尿病或高血压的发病率较高。目的 确定动脉高血压成人慢性肾脏病发病的相关风险因素。材料和方法 对在一家初级保健医院接受治疗的 455 名高血压患者进行回顾性队列研究。研究人员查阅了病历和实验室资料,以诊断慢性肾脏病及其分期。研究纳入了年龄在 40 岁及以上、在 2015 - 2017 年间接受评估的男女患者。通过逻辑回归分析,确定了与慢性肾脏病发展相关的风险因素。结果 63.7%为女性,36.3%为男性。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和高血压控制,当年主要使用洛沙坦(53%)进行肾脏保护。男性(OR 1.68,CI 1.03-2.76)、年龄:60 岁或以上(OR 6.38,CI 2.65-15.37)和贫血(OR 1.71,CI 1.03-2.85)是慢性肾病发病的危险因素(P < 0.05),而肾保护(OR 0.39,CI 0.18-0.88)和糖尿病控制(OR:0.18,CI 0.07-0.47)则是保护因素(P < 0.05)。2015年和2017年的慢性肾病患病率分别为19%和45%,以G2类为主。对比组为研究中每年分析的同一队列。结论 男性、60 岁以上和贫血是慢性肾脏病的风险因素。肾脏保护、糖尿病控制和患者随访是预防慢性肾脏病发生的因素。
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Factors Associated with the Development of Chronic Kidney Disease in Patients with Arterial Hypertension
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.
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