南京市65岁及以上社区体检人群慢性肾脏病的流行现状及影响因素分析

doi:10.3969/j.issn.1003-9198.2026.02.014

摘要/Abstract

摘要： 目的了解南京市65岁及以上社区体检人群慢性肾脏病(chronic kidney disease,CKD)的流行现状及其影响因素。方法采用横断面研究设计,调查对象为参与2022年南京市国家基本公共卫生服务项目健康管理的65岁及以上老年人,在全市范围内按照一定比例随机抽取6000人纳入分析。根据CKD-EPI方程计算估算的肾小球滤过率(eGFR),将eGFR<60 mL/(min·1.73 m²)定义为CKD。采用t检验和χ²检验比较CKD组与非CKD组间临床资料的差异,采用单因素和多因素logistic回归模型分析CKD患病的风险因素。结果南京市社区健康管理老年人群的CKD患病率为10.6%(95%CI:9.82%~11.38%)。CKD组与非CKD组的年龄、性别、文化程度、血压、婚姻状况、饮酒情况,以及FPG、TC、TG、HDL-C、LDL-C、BUN水平之间差异存在统计学意义(P均<0.05)。单因素logistic回归分析结果显示,年龄≥70岁、女性、糖尿病、高血压、低HDL-C血症、高TG血症、BUN和总胆红素(total bilirubin,TBIL)异常与CKD的患病风险呈正相关(P均<0.05),接受高等教育和经常饮酒则与CKD的患病风险呈负相关(P均<0.05)。多因素logistic回归分析结果显示,年龄≥70岁、女性、吸烟、高血压、糖尿病、高TG血症、低HDL-C血症、BUN和TBIL异常显著增加CKD的患病风险,而经常饮酒则会降低CKD的患病风险。结论年龄、性别、高血压、糖尿病、血脂异常以及BUN和TBIL异常与CKD的发生密切相关,应控制老年人的血压、血糖、血脂、BUN、TBIL等指标,预防老年人CKD的发生和发展。

关键词: 慢性肾脏病, 血脂异常, 影响因素, 国家基本公共卫生服务项目

Abstract: Objective To investigate the prevalence of chronic kidney disease (CKD) and its influencing factors among community-based elderly individuals undergoing health examinations in Nanjing. Methods A cross-sectional study was conducted among adults aged 65 years and older who were enrolled in the National Essential Public Health Service project in Nanjing in 2022. A total of 6000 participants were randomly selected using proportional sampling for analysis. CKD was defined as an estimated glomerular filtration rate (eGFR)<60 mL/(min·1.73 m²) calculated using the CKD-EPI equation. T-tests and chi-square tests were used to compare differences in the clinical data between the CKD group and the non-CKD group. Univariate and multivariate logistic regression models were employed to analyze the risk factors of CKD. Results The overall prevalence of CKD among the elderly in the community health management program in Nanjing was 10.6% (95%CI: 9.82%-11.38%). There were significant differences in age, gender, education level, blood pressure, marital status, alcohol consumption, as well as the levels of fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and blood urea nitrogen (BUN) between the CKD group and the non-CKD group (all P<0.05). Univariate logistic regression analysis revealed that age ≥70 years, female, diabetes, hypertension, low HDL-C, high TG, and abnormal levels of BUN and total bilirubin (TBIL) were positively associated with the risk of CKD (all P<0.05). In contrast, higher education and regular alcohol consumption were negatively associated with the risk of CKD (all P<0.05). Multivariate logistic regression analysis indicated that age ≥70 years, female, smoking, hypertension, diabetes, high TG, low HDL-C, and abnormal levels of BUN and TBIL significantly increased the risk of CKD, while regular alcohol consumption was associated with a reduced risk. Conclusions Age, gender, hypertension, diabetes, dyslipidemia, and abnormal levels of BUN and TBIL are closely associated with the occurrence of CKD in the elderly. Measures should be taken to control blood pressure, blood glucose, blood lipids, BUN, and TBIL levels in the elderly to prevent the onset and progression of CKD.

Key words: chronic kidney disease, dyslipidemia, influencing factor, National Essential Public Health Service

中图分类号:

黄昱铖, 胡彩红, 叶青, 许慧清, 徐斐, 王志勇. 南京市65岁及以上社区体检人群慢性肾脏病的流行现状及影响因素分析[J]. 实用老年医学, 2026, 40(2): 174-179.

HUANG Yucheng, HU Caihong, YE Qing, XU Huiqing, XU Fei, WANG Zhiyong. Prevalence and influencing factors of chronic kidney disease among community-dwelling individuals aged 65 and above in Nanjing[J]. Practical Geriatrics, 2026, 40(2): 174-179.

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