高龄原发性高血压患者合并慢性肾脏病的危险因素

Risk factors for essential hypertension complicated with chronic kidney disease in ≥80 years old patients

摘要:

目的 了解80岁以上原发性高血压(EH)住院患者合并慢性肾脏病(CKD)的情况,分析相关危险因素。方法 选取南京医科大学第二附属医院心血管内科住院的1 555例65岁以上EH患者,依据是否≥80岁分为2组:高龄组(n＝575)和非高龄组(n＝980)。收集患者的临床资料。采用SPSS 22.0软件进行数据处理,logistic回归分析EH合并CKD的危险因素。结果 与非高龄EH组患者比较,高龄EH组患者CKD发生率显著升高(52.9% vs 29.5%,P＜0.05)。高龄EH患者合并CKD的危险因素依次为高尿酸血症(OR=2.514,95%CI 1.750～3.611；P＜0.001)、年龄(OR=1.072,95%CI 1.018～1.129；P=0.009)和收缩压(OR=1.019,95%CI 1.011～1.028；P＜0.001),保护因素为高密度脂蛋白胆固醇(OR=0.516,95%CI 0.315～0.847；P=0.009)；非高龄老年EH患者合并CKD的危险因素依次为高尿酸血症(OR=2.729,95%CI 1.991～3.740；P＜0.001)、糖尿病(OR=1.944,95%CI 1.420～2.662；P＜0.001)、年龄(OR=1.140,95%CI 1.101～1.182；P＜0.001)和收缩压(OR=1.009,95%CI 1.003～1.016；P=0.007),保护因素为高密度脂蛋白胆固醇(OR=0.448,95%CI 0.278～0.722；P=0.001)。结论 高龄老年EH患者合并CKD的比例显著高于非高龄老年EH患者,高龄EH患者合并CKD与高尿酸血症、年龄、收缩压及高密度脂蛋白胆固醇水平有关。

Abstract:

Objective To analyze the risk factors for chronic kidney disease (CKD) complication in essential hypertension (EH) patients ≥80 years of age. Methods A total of 1 555 elderly EH patients aged over 65 years old admitted to our department during March 2014 and June 2017 were enrolled in this study. They were assigned into ≥80-year-old group (n=575) and <80-year-old group (n=980). Their clinical data were collected and analyzed. SPSS statistics 22.0 was used to analyze the data, and logistic regression analysis was employed to identify the risk factors for CKD. Results Compared with <80-year-old group, ≥80-year-old group had significantly higher incidence of CKD (52.9% vs 29.5%, P<0.05). In ≥80-year-old EH patients, the risk factors for CKD were hyperuricemia (OR=2.514, 95%CI 1.750-3.611; P<0.001), age (OR=1.072,5%CI 1.018-1.129; P=0.009) and systolic blood pressure (OR=1.019,5%CI 1.011-1.028; P<0.001), and the protective factor was high-density lipoprotein cholesterol (OR=0.516, 95%CI 0.315-0.847; P=0.009). While, for <80-year-old EH patients, the risk factors were hyperuricemia (OR=2.729, 95%CI 1.991-3.740; P<0.001), diabetes mellitus (OR=1.944,5%CI 1.420-2.662; P<0.001), age (OR=1.140, 95%CI 1.101-1.182; P=0.009) and systolic blood pressure (OR=1.009,5%CI 1.003-1.016; P=0.007), and the protective factor was high-density lipoprotein cholesterol (OR=0.448,5%CI 0.278-0.722; P=0.001). Conclusion The incidence rate of CKD in ≥80-year-old EH patients is obviously higher than that in <80-year-old EH patients. The complication of CKD is associated with age, hyperuricemia, systolic blood pressure and high-density lipoprotein cholesterol in ≥80-year-old EH patients.