标题：肾小球滤过率与肾脏替代治疗启动的相关性研究

      作者：刘伟俊 1，2，吴锡信 1，2    1.广东医科大学研究生院，广东 湛江 524023；2.广东省第二人民医院肾内科，广东 广州 510317

      卷次： 2020年31卷15期

      【摘要】 目的 探讨慢性肾脏病(CKD) 3~4期患者的初始实测肾小球滤过率(mGFR)与 2年内进展至肾脏替代治疗(RRT)的相关性。方法 收集153例2012年1月至2018年1月期间在广东省第二人民医院肾内科就诊并检测 99mTc-DTPA清除率评估肾小球滤过率(GFR)为CKD 3~4期患者的临床资料。通过多元回归调整原发肾脏病、高血压病、糖尿病、尿蛋白、血红蛋白、肌酐、尿素氮、β2微球蛋白(β2M)、胱抑素C、白蛋白等混杂因素，评估初始mGFR与 2年RRT启动的独立相关性。结果 初始mGFR与 2年RRT启动风险呈显著负相关(HR=0.71，95%CI为 0.52~0.98，P=0.039)，即在调整其他混杂因素后，初始mGFR每下降 5 mL/(min·1.73 m2)，CKD患者 2年RRT启动风险将增加29%。结论 初始mGFR能为CKD 3~4期患者2年RRT启动风险提供重要信息。
      【关键词】 慢性肾脏病；肾小球滤过率；肾脏替代治疗；相关性；进展；风险评估；多重插补
      【中图分类号】 R692 【文献标识码】 A 【文章编号】 1003—6350（2020）15—1930—06

Correlation between glomerular filtration rate and initiation of renal replacement therapy.
LIU Wei-jun1，2, WUXi-xin 1，2. 1. Graduate School, Guangdong Medical University, Zhanjiang 524023, Guangdong, CHINA; 2. Department ofNephrology, the Second People's Hospital of Guangdong Province, Guangzhou 510317, Guangdong, CHINA
【Abstract】 Objective To investigate the correlation between the initial measured glomerular filtration rate(mGFR) and the progression to renal replacement therapy (RRT) within two years in patients with chronic kidney dis-ease (CKD) at 3-4 stages. Methods The clinical data of 153 patients, who admitted to Department of Nephrology, theSecond People's Hospital of Guangdong Province from January 2012 to January 2018, were collected. The glomerular fil-tration rate (GFR) of these patients as CKD 3-4 were evaluated by detecting 99mTc DTPA clearance rate. Multiple regres-sion was used to adjust the confounding factors of primary kidney disease, hypertension, diabetes mellitus, urinary pro-tein, hemoglobin, creatinine, urea nitrogen, β2-microglobulin (β2M), Cystatin C and albumin, to evaluate the independentcorrelation between initial mGFR and 2-year RRT initiation. Results There was a significant negative correlation be-tween initial mGFR and 2-year RRT initiation (HR=0.71, 95%CI=0.52 to 0.98, P=0.039). After adjusting for other con-founding factors, for every 5 mL/(min·1.73 m2) decrease in initial mGFR, the risk of RRT initiation in CKD patientswill increase by 29% in two years. Conclusion The initial mGFR can provide important information for the risk ofRRT initiation in CKD 3-4 patients.
      【Key words】 Chronic kidney disease (CKD); Glomerular filtration rate (GFR); Renal replacement therapy(RRT); Correlation; Progress; Risk assessment; Multiple imputation