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目的探讨慢性肾脏病(CKD)非透析患者维生素D缺乏与不足的发生率,并分析其危险因素。方法收集130例CKD非透析患者的临床资料,包括血清25-羟基维生素D_3[25(OH)D_3]、血清白蛋白、肾功能、24-h尿生化、尿量等,计算维生素D缺乏和不足的发生率,并分析导致维生素D水平下降的相关因素。结果维生素D缺乏的发生率为13.8%,而维生素D不足的发生率为80.8%。随着CKD分期增加,血清25(OH)D_3水平逐渐降低(P<0.05)。24-h尿蛋白≤1.5g/d患者的25(OH)D_3水平高于24-h尿蛋白>1.5g/d患者[(40.43±15.32)μg/L vs.(25.59±16.12)μg/L](P<0.05)。血清白蛋白>35g/L患者的25(OH)D_3水平高于血清白蛋白≤35g/L患者[(45.65±16.14)μg/L vs.(28.55±10.14)μg/L](P<0.05)。多元线性回归分析显示,低白蛋白血症、eGFR降低与维生素D缺乏和不足的发生有关(P<0.01)。结论 CKD非透析患者维生素D水平下降发生率高,低白蛋白血症、eGFR降低是导致其发生的独立危险因素。
Objective To investigate the incidence of vitamin D deficiency and deficiency in non-dialysis patients with chronic kidney disease (CKD) and analyze its risk factors. Methods The clinical data of 130 CKD non-dialysis patients were collected, including serum 25-hydroxyvitamin D 3 [25 (OH) D 3], serum albumin, renal function, 24-h urine biochemistry, The incidence of vitamin D and analysis of the factors that lead to the decline in vitamin D levels. Results The incidence of vitamin D deficiency was 13.8%, while the incidence of vitamin D deficiency was 80.8%. Serum 25 (OH) D_3 level gradually decreased with the increase of CKD stage (P <0.05). 25 (OH) D_3 in patients with 24-h urinary protein ≤1.5g / d was significantly higher than that in patients with 24-h urinary protein> 1.5g / d [(40.43 ± 15.32) μg / L vs. (25.59 ± 16.12) μg / L ] (P <0.05). The level of 25 (OH) D_3 in patients with serum albumin> 35g / L was higher than that in patients with serum albumin ≤35g / L [(45.65 ± 16.14) μg / L vs. (28.55 ± 10.14) μg / L] . Multivariate linear regression analysis showed that hypoalbuminemia, eGFR decreased with vitamin D deficiency and deficiency (P <0.01). Conclusion There is a high incidence of vitamin D deficiency in CKD non-dialysis patients. Hypoalbuminemia and eGFR decrease are independent risk factors.