Analysis Of Risk Factors Associated With Dyslipidemia In 204 Patients With Chronic Kidney Disease

Research background:Chronic kidney disease(CKD)has a high incidence and has become one of the world public health problems that endanger human health.Epidemiological studies have shown that the number of new ESRD per year has exceeded the annual population growth rate.According to the study,the prevalence of CKD in Chinese adults is 10.8%,and it is estimated that there are at least 120 million CKD patients in China.Dyslipidemia is one of the major complications of chronic kidney disease.It not only aggravates the progression of CKD disease,but also increases the risk of cardiovascular disease(CVD),which seriously affects the quality of life and survival of patients with CKD.Therefore,in order to avoid and control the factors related to dyslipidemia in patients with CKD and improve the quality of life and survival of patients with CKD,we initially studied the incidence of dyslipidemia and related risk factors in patients with CKD.Research objectives:Preliminary study on the occurrence of dyslipidemia and related risk factors in204 patients with CKD.Research methods:During the period from May 2017 to May 2018,204 patients with complete CKD data were admitted to the Department of Nephrology,First Hospital of Jilin University.The records included:gender,age,primary disease,previous hypertension and diabetes history,smoking history,drinking history,height at admission,weight,hemoglobin(Hb),uric acid(UA),serum triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HLD-C),serum albumin(Alb),hypersensitive C-reactive protein(CRP),serum parathyroid hormone(PTH),direct bilirubin(DBil),Indirect bilirubin(IBil),totalbilirubin(TBil),24-hour urine protein quantitation,24-hour urine microalbumin.According to the 2016 Chinese guidelines for prevention and treatment of dyslipidemia in adults,dyslipidemia is classified into four categories: hypercholesterolemia,hypertriglyceridemia,mixed hyperlipidemia,and low-density lipoproteinemia.Dyslipidemia were compared in patients with CKD.Statistical analysis was performed on the data using SPSS 23.0.The measurement data were tested by normality,and the data conforming to the normal distribution were expressed as mean ± standard deviation(`X±S).Data that did not conform to the normal distribution were expressed as median(quartile),and Kruskal-Wallis rank sum test was used for comparison between groups.The classification and count data were expressed by the number of cases(percentage),and the chisquare test was used for comparison between groups.Pearson correlation analysis was used to analyze the correlation between the indicators.Multivariate linear regression analysis was used for multivariate analysis.The test levels were all P<0.05,and P<0.01 was statistically significant.Research results:1.Dyslipidemia in patients with CKD: A total of 204 patients with CKD were enrolled in this study,and 117 patients with dyslipidemia accounted for 57.35%.Among them,38 patients with CKD 1-3 and 21 patients with dyslipidemia accounted for 55.3%.There were 37 patients with CKD4 and 27 patients with dyslipidemia,accounting for 73%.There were 129 patients with CKD5 and 69 patients with dyslipidemia,accounting for 53.5%.The prevalence of dyslipidemia in patients with CKD is high.The dyslipidemia of CKD1-3 patients is mainly hypertriglyceridemia.The dyslipidemia of CKD 4 and CKD5 patients is mainly low-density lipoprotein.2.Risk factors for dyslipidemia in patients with CKD: Blood lipid levels and age,BMI,hemoglobin,serum albumin,parathyroid hormone,direct bilirubin,indirect bilirubin,total bilirubin,24-hour urine by Pearson correlation analysis Protein quantification,24-hour urine microalbumin analysis.Total cholesterol levels were found to be significantly different from direct bilirubin,total bilirubin,albumin,hemoglobin,24-hour urine protein quantitation,and 24-hour urine microalbumin(P<0.05).There were significant differences in the levels of triglyceride and BMI,total bilirubin,direct bilirubin,hemoglobin,24-hour urine protein,and 24-hour urine microalbumin(P<0.05).There was a statistically significant difference between high-density lipoprotein cholesterol and BMI(P<0.05).There was a significant difference between low-density lipoprotein cholesterol level and hemoglobin(P<0.05).Multiple linear regression analysis of dyslipidemia showed that total cholesterol levels were positively correlated with hemoglobin and 24-hour urine protein quantitation,and negatively correlated with direct bilirubin.Triglyceride levels are positively correlated with hemoglobin levels.High-density lipoprotein cholesterol levels were positively correlated with hemoglobin levels and negatively correlated with BMI.Low-density lipoprotein cholesterol levels were positively correlated with 24-hour urine protein quantitation.Research conclusions:1.The prevalence of dyslipidemia in patients with CKD was high,at 57.3%.The prevalence of dyslipidemia was 55.3% in patients with CKD1-3,the prevalence of dyslipidemia in patients with CKD4 was 73.0%,and the prevalence of dyslipidemia in patients with CKD5 was 53.5%.Hyperlipidemia is the main manifestation of dyslipidemia in patients with CKD1-3,and dyslipidemia in patients with CKD4 and 5 is characterized by low-density lipoproteinemia.2.2.Cholesterol were positively correlated with hemoglobin,24-hour urine protein quantitation,and negatively correlated with serum direct bilirubin.Triglyceride are positively correlated with hemoglobin.High-density lipoprotein were positively correlated with hemoglobin and negatively correlated with BMI.Low-density lipoprotein were positively correlated with 24-hour urine protein quantitation.