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目的探讨上海市浦东新区居民慢性肾病(CKD)发病情况及其危险因素。方法采取多阶段分层整群抽样方法,选取上海市浦东新区符合纳入标准的15岁以上常住居民5 204人,2008年3月至2013年12月进行队列研究,采用COX回归模型探索慢性肾病与糖尿病、血脂异常的相关性。结果 2008-2013年CKD累计发病率11.24%,发病密度为17.77/千人年;男性和女性发病率分别为6.77%和14.69%,差异有统计学意义(χ2=54.910,P<0.01),发病密度分别为10.44/千人年和23.71/千人年。CKD发病的独立危险因素是女性(RR=2.233,95%CI:1.781~2.800);老龄化(60~74岁RR=1.594,95%CI:1.254~2.025,≥75岁RR=1.658,95%CI:1.050~2.620);低教育程度(初中RR=1.487,95%CI:1.105~2.001,小学及以下RR=1.402,95%CI:1.109~1.772);患有糖尿病(RR=1.461,95%CI:1.097~1.945)或血脂异常(RR=1.281,95%CI:1.046~1.570)。结论浦东新区15岁以上常住居民CKD发病率较高,建议改善居民膳食结构和生活方式、合理规律使用药物等措施,控制慢性疾病的发生发展,同时重视CKD的干预,遏制CKD病程进展。
Objective To investigate the incidence and risk factors of chronic kidney disease (CKD) in Shanghai Pudong New Area. Methods A multistage stratified cluster sampling method was used to select 5 204 permanent residents above 15 years old who met the inclusion criteria in Pudong New District, Shanghai. A cohort study was conducted from March 2008 to December 2013. The COX regression model was used to explore the relationship between chronic kidney disease and Diabetes, dyslipidemia correlation. Results The cumulative incidence of CKD in 2008-2013 was 11.24% with a density of 17.77 per thousand years. The incidence of CKD in males and females was 6.77% and 14.69%, respectively, with significant difference (χ2 = 54.910, P <0.01) The density was 10.44 per thousand person-years and 23.71 per thousand person-years, respectively. The independent risk factors of CKD were female (RR = 2.233, 95% CI: 1.781-2.800); aging (60-74 years old RR = 1.594,95% CI: 1.254-2.025, ≥75 years old RR = 1.658,95% CI: 1.050-2.620); low education level (junior high school RR = 1.487, 95% CI: 1.105-2.001, elementary school and below RR = 1.402, 95% CI: 1.109-1.772); with diabetes (RR = 1.461, 95% CI: 1.097-1.945) or dyslipidemia (RR = 1.281, 95% CI: 1.046-1.570). Conclusions The incidence of CKD is higher in permanent residents over the age of 15 in Pudong New District. It is suggested to improve the dietary patterns and lifestyle of residents, and to use drugs rationally to control the occurrence and development of chronic diseases. At the same time, CKD should be taken seriously to curb the progression of CKD.