Epidemiological Investigation Of Chronic Kidney Disease In The Elderly In The Rural Area Of Yangzhou City

Objective:To investigate the epidemiological characteristics and related influencing factors of chronic kidney disease in the elderly in the rural area of Yangzhou City,to provide a scientific basis for local formulation of CKD management measures,and to reduce the incidence of ESRD.Methods:From June 1st to 15th,2020,the resident elderly physical examination was carried out in Huangcheng Town,Baoying County,Yangzhou City to screen for chronic kidney disease.Select resident residents(referring to household registration and non-residential residents who have lived in the local area for more than 10 years)as the screening objects,and those with mental illness who cannot cooperate with the investigation were excluded.Screening items included questionnaire surveys,measurement of height,weight,blood pressure and laboratory examinations.Laboratory tests included fasting blood glucose,triglycerides,total cholesterol,high density lipoprotein,low density lipoprotein,urea nitrogen,blood creatinine,qualitative detection of urine protein.Enter the general information and laboratory test results of all participants for data analysis,calculate the prevalence of CKD and the proportion of stages,and use SPSS 26.0 for statistical analysis to compare the general data and biochemistry of CKD and non-CKD patients and CKD patients at various stages Index,using logistic regression to analyze the influencing factors of CKD in the elderly in this area.Results:1.There were 1892 people with complete information of the participants in this physical examination project,with an average age of 71.99±5.21 years old.Among them,874 were males and 1018 were females,with a male-to-female ratio of 1:1.17.In the total population,the prevalence of hypertension was 33.51%,the prevalence of diabetes was 13.32%,the prevalence of hypertriglyceridemia was 25.79%,the prevalence of hypercholesterolemia was 15.01%,and the prevalence of overweight was 41.81%,and the prevalence of obesity was 13.64%.2.The screening results showed that the prevalence of CKD in the elderly in the region was 11.63%(including 99 men and 121 women).The prevalence of CKD in men and women was 11.33%and 11.89%.There was no difference in the gender distribution of CKD patients(P>0.05).Among CKD patients,there were 145 patients with impaired renal function,with a prevalence rate of 7.66%;47 patients with proteinuria,with a prevalence rate of 2.48%;53 patients with hematuria,with a prevalence rate of 2.80%.There was no statistically significant difference in the gender distribution of renal function decline,proteinuria,and hematuria in CKD patients(P>0.05).3.In the screening population,the prevalence rate of CKD stage 1 was 1.64%,accounting for 14.09%of CKD patients;the prevalence rate of CKD stage 2 was 2.33%,accounting for 20.0%of CKD patients;the prevalence rate of CKD stage 3 was 7.08%,accounting for 60.91%of CKD patients;the prevalence rate of CKD stage 4 was 0.48%,accounting for 4.09%of CKD patients;the prevalence rate of CKD stage 5 was 0.11%,accounting for 0.91%of CKD patients.4.CKD patients were grouped by 10 years of age increased.The prevalence of CKD was 9.47%for people between 65 and 75 years old(not including 75 years old).The prevalence of CKD was 16.23%for those between 75 and 85 years old(not including 85 years old).The prevalence of CKD was 25.53%for persons aged 85 years and above.As age increased,the prevalence of CKD gradually rised.The prevalence of CKD in different age groups was significantly different(P<0.001).5.The prevalence of CKD in hypertensive patients was 17.03%(108/634);the prevalence of CKD in diabetic patients was 17.06%(43/252);the prevalence of CKD in patients with hypertriglyceridemia 13.73%(67/488);the prevalence of CKD in hypercholesterolemia patients was 14.44%(41/284);the prevalence of CKD in overweight people was 12.01%(95/791);the prevalence of CKD in obese people was 13.57%(35/258).The prevalence of CKD in patients with hypertension,diabetes and obesity was higher than that in patients without corresponding chronic diseases,and the differences were statistically significant(all P<0.05).The staging of CKD patients in various chronic disease patients was mainly in the third stage.6.There were 16 CKD patients whose blood pressure was controlled within the treatment target range,and the compliance rate was 14.81%(16/108).There were 8 CKD patients whose fasting blood glucose was controlled within the treatment target range,and the rate of compliance was 18.60%(8/43).7.Compared with non-CKD patients,CKD patients were older,their systolic blood pressure,fasting blood glucose,triglyceride,urea nitrogen,and blood creatinine levels were higher,and their high-density lipoprotein and eGFR levels were lower.The difference was statistically significant(all P<0.05).There were no significant differences in gender distribution,systolic blood pressure,diastolic blood pressure,BMI,total cholesterol,and low-density lipoprotein levels(all P>0.05).8.Since the number of CKD stage 4 and stage 5 patients was small,the two groups were combined into one group for comparison with CKD stage 1 to 3 patients.The results showed that compared with patients with early CKD,patients with advanced CKD were older,the difference was statistically significant(P<0.001);similar to patients with CKD stage 1,the systolic blood pressure level of patients with CKD stage 4 and stage 5 was higher,and the fasting blood glucose level of patients with CKD stage 3 was higher(P<0.05);in gender distribution,BMI,diastolic blood pressure,triglycerides,total cholesterol,high-density lipoprotein,low density lipoprotein,there was no statistically significant difference(P>0.05).9.Spearman correlation analysis results showed that eGFR was negatively correlated with age,fasting blood glucose,and urea nitrogen(r=-0.320,-0.179,-0.520,all P<0.05).10.The CKD in the elderly was used as the dependent variable,and gender,age,hypertension,diabetes,hypertriglyceridemia,hypercholesterolemia,overweight,and obesity were used as covariates to conduct a binary multivariate logistic regression analysis The results showed that age,hypertension,and diabetes were risk factors for CKD in the elderly(OR=1.087,95%CI 1.059-1.115;OR=1.816,95%CI 1.358-2.428;OR=1.751,95%CI 1.203-2.547,P<0.05).11.Among the hypertension patients,the prevalence of CKD was lower in those with standard blood pressure control than in those without standard blood pressure control,and the difference was statistically significant x2=5.134,P<0.05).Among diabetic patients,the prevalence of CKD was lower in those with standard FPG control than in those without standard FPG control,but the difference was not statistically significant(x2=1.131,P>0.05).Conclusion:1.The prevalence of CKD in the elderly in rural areas of Yangzhou was 11.63%,and the prevalence gradually increases with age.The main manifestation of kidney damage was the decline in eGFR.The stage of CKD patients in the elderly in this area was mainly in stage 3,followed by stage 2,stage 1,and stage 4.The number of CKD stage 5 was the least.2.Age,hypertension,and diabetes were independent risk factors for CKD in the elderly in this area.3.The control rate of blood pressure and fasting blood sugar of the elderly with CKD combined with hypertension and diabetes in this area was low.