| Objective : To analyze the clinical features of Chronic Kidney Disease (CKD) in elderly patients and provide help for diagnosis and treatment of CKD. Identify the causes of CKD in high-risk groups (elderly residents) and provide a strong basis for early clinical discovery of CKD. Through the analysis of the clinical features and etiology of the aged CKD, the early prevention and control of the elderly CKD was directed to improve the quality of life of patients and prolong the patient's survival time. A retrospective analysis of the basic information of the hospitalized patients who were admitted to the hospital in the first affiliated hospital of kunming medical university in January 1, 2016, on December 31, 2016. The exclusion conditions are as follows: age < 65; The history is less than 3 months; Patients with incomplete data.Results: 1.The total survey of 2198 people, including 310 people aged 65 and 310,aged CKD286, 92.26%, and elderly non-ckd24, 7.74%. Male 192 men, 61.94 percent,and 118 women, 38.06 percent, with an average age of 72.49 plus or minus 5.543 years. In all ages, it was less than 65 at the age of 65 and 115 at the age of 69,accounting for 37.10 percent, 79-75 years and 109, 35.16 percent, 76-80 years, 58 people, 18.71 percent, or 81 years and 28 people, accounting for 9.03 percent. Elderly CKD installments, stage G1, G2, G3a, stage G3b, G4 and G5 period, respectively, 135,28 people,21 people,49, 44 people, 9 people,respectively, 47.20%,9.79%,7.34%,17.13%, 7.34% and 3.15%.2.The survey study found that older in the etiology of chronic kidney disease(CKD),hypertension,178, 36 (62.24%),diabetes,25 (12.59%),chronic nephritis,22(8.74%),gout,chronic interstitial nephritis (7.96%),8 people,accounting for 2.8%,4 connective tissue diseases,3 (1.40%),polycystic kidney,accounted for 1.05%,other 10 people, accounting for 3.50%. The main cause of CKD is hypertension.3.The study found that the etiology of the aged CKD was 60.95 percent,61.54 percenrt, 61.54 percent, 61.54 percent, 61.54 percent, 61.54 percent, 61.54 percent,61.54 percent,61.54 percent,61.54 percent,61.54 percent,61.54 percent,61.54 percent, 61.54 percent. G1, G2, G3a, G3b, G4 and G5 were 60.74%, 60.71%,57.14%, 65.91%, 65.91% and 66.67% respectively. Sixty-five percent of patients with dialysis, 14.68 percent, and 221 percent of non-dialysis patients, 77.27 percent. High blood pressure is the main cause of the age and age of CKD.4.By the chi-square test analysis found that older group with elderly CKD,chronic kidney disease (CKD) age (chi-square = 2.562, p = 2.562), no statistical difference of gender (chi-square ? 11.849, p = 11.849), urine protein (chi-square =19.903, p < 0.001), urine occult blood (chi-square = 6.673, p = 0.010) statistically significant. Older CKD men (96.35%) were older than wormen (85.59%).5.The t test analysis found that elderly CKD with elderly CKD group total cholesterol (t = 1.457, p = 1.457),calcium (t = 0.244, p = 0.244),albumin (t = 0.275,p = 0.275) no statistical difference; Elderly CKD group with elderly CKD hemoglobin(t = 6.556, p < 0.001),red blood cells (t = 4.970, p < 0.001),uric acid (t = 3.323, p =3.323), p (t = 3.805, p = 3.805) was statistically difference, elderly CKD hemoglobin,red blood cells is lower than the elderly CKD groups; The elderly CKD group had uric acid and higher phosphorus than the non-ckd group.6.The rank and test analysis found that the aged CKD group had no statistical difference (Z = 1.083, p = 0.191) in the elderly non-ckd group. The aged CKD group and the elderly non-ckd group urea (Z = 2.737, p < 0.001), creatinine (Z = 3.079, p <0.001), cytae - C (Z = 3.064, p < 0.001) were statistically different; The elderly CKD group urea, creatinine, and cyste-c were higher than the older non-ckd groups.7.By variance analysis found that elderly CKD group periods of uric acid (F =1.709, p = 1.709), calcium (F = 1.684, p = 1.684), albumin (F = 2.027, p = 2.027) no statistical difference; The elderly CKD group of each period hemoglobin (F = 42.715,p < 0.001), red blood cells (F = 37.893, p < 0.001),phosphorus (F = 31.121,p < 0.001)were statistically different; Two or two analyses found that hemoglobin and red blood cells were gradually decreasing from G1 to G3b, which gradually increased from G1 to G4.8.The rank and test analysis found that the aged CKD group had no statistically significant differences in triglycerides (H = 5.184, p = 0.398). The elderly CKD group had different urea (H = 187.741,p < 0.001),creatinine (H = 248.711,p < 0.001),cytae (H = 200.387, p < 0.001); Two or two comparative analyses found that urea,creatinine, and cyste-c increased from GI to G5.9.By Logistic single factor regression analysis found that urea (P = 0.00, OR =0.00, 95 c. i. % =1.157 -1.585), creatinine (P = 0.02, OR = 0.02, 95 c. i. = 1.004-1.108) %,uric acid (P = 0.001,OR= 0.001,95 c. i. = 1.003 -1.011) %,(inhibition - C(P < 0.001,OR = 4.765, 95 c. i, % = 2.304-9.851),phosphorus (P = 0.019, OR =0.019, 95 c. i. % = 1.289 -18.032), red blood cells (P = 0.002, OR = 0.002, 95 c. i. %=0.285 0.750), hemoglobin (P = 0.001, OR = 0.001, 95 c. i. % = 0.957- 0.988), urine protein A3 period (P = 0.014, OR = 0.014, 95 c. i. = 1.282- 9.037), urine occult blood(P = 0.014, OR = 0.014, 95 c. i. = 1.276- 8.578) for elderly CKD sensitive indicators,statistically significant.10.The multi-factor logistic regression analysis found that the elf inhibition -C (P = 0.001, OR = 3.4, 95% ci = 1.687- 6.855) was found early sensitive indicator of elderly chronic kidney disease (CKD), statistically significant (P = 0.001).11.When the threshold of creatinine was 123.80 umol/L, its specificity was 0.917, sensitivity 0.738; When the critical value of cyscatin-C was 1.88 mg/L, it was 0.875 and sensitivity 0.776, which may be the best critical point for diagnosing early renal impairment. Creatinine and urinary cyscatin - C determination results do ROC curve, creatinine area under the curve is 0.864, the elf inhibition - the area under the curve C is 0.886, both has high diagnostic value to the diagnosis of senile chronic kidney disease (CKD), and bladder cyscatin-C creatinine had higher diagnostic value.12.The study found that the number of elderly CKD deaths was 3.15%, and non-ckd deaths were zero. The cause of death of CKD in aged CKD, 5 people with high blood pressure, 55.55 percent, 2 people with diabetes, 22.22 percent, gout 1, 1.11 percent, and 11.11 percent. Among the causes of the death of CKD, the number of organ failure was 66.67 percent, 2 people with hypertoxicosis, 22.22 percent, and lung infection 11.11 percent. The main cause of death in elderly CKD is high blood pressure,mainly due to multiple organ failure.Conclusion:1. High blood pressure, diabetes, chronic nephritis, for a common cause of chronic kidney disease (CKD), the main disease because of high blood pressure,followed by chronic nephritis, diabetes, gout, chronic interstitial nephritis, connective tissue disease, polycystic kidney.2. Single factor regression analysis found that the Logistic, urea, creatinine, uric acid, the elf cyscatin-C, phosphorus, RBC, hemoglobin, urine protein, urine occult blood is a sensitive indicator of elderly chronic kidney disease (CKD).3.According to the analysis of Logistic factors, cyscatin-C is an early sensitive indicator of CKD in old age.4.The results of the ROC curve for creatinine and cyscatin-C were highly diagnostic for the diagnosis of the aged CKD, and the value of the diagnosis was higher than that of creatinine.5.The main death of CKD in old age is caused by high blood pressure, mainly due to multiple organ failure. |
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