The Study On The Clinical Characteristics And Risk Factors Of Chronic Kidney Disease And Hyperuricemia

Objective: To investigate the clinical characteristics and risk factors in chronic kidney disease and hyperuricemia.Methods: A total of 1869 people in the inpatient department of Nephrolog y and the physical examination center of the Second Hospital of Lanzhou Univ ersity were enrolled in this study from January 2014 to December 2017.The n ames,gender,age and past medical history(including whether patients had hyp ertension,diabetes mellitus and chronic kidney disease)of the investigated pop ulation were collected.In addition,blood routine,biochemical and 24-hour urin ary protein quantity of the investigated population were collected.If patients wi th chronic kidney disease appeared in the investigated population,it was necess ary to collect body component analysis of patients with chronic kidney disease.According to the diagnostic criteria of clinical guidelines for chronic kidney d isease and hyperuricemia,the investigated population was divided into four gro ups: normal group,hyperuricemia group,chronic kidney disease group and chro nic kidney disease accompanied by hyperuricemia group.Firstly,the differences of clinical commonly used indicators in the four groups were analyzed;then,the chronic kidney disease group was divided into three groups according to th e level of eGFR,and the differences of clinical commonly used indicators at d ifferent levels of renal function were analyzed;and the inter-group difference d ifferences of body component analysis of different renal functions in chronic ki dney disease group were calculated;secondly,the normal group and hyperurice mia group were divided into three groups according to the level of uric acid,and the differences of clinical indicators with uric acid level were analyzed under different uric acid levels.Finally,the related clinical indicators of hyperuric emia and chronic kidney disease were included in the covariates of ordinal log istic regression for single factor and multiple factors analysis.Results:(1)This study included 1869 people in the inpatient department of Nephrology and physical examination center of the Second Hospital of Lanzhou University from January 2014 to December 2017.According to the exclusion criteria,1734 patients were finally included.Among them,245 were in the normal group,376 in HUA group,599 in CKD group and 514 in CKD accompanied by HUA group.There were statistically significant differences in gender,the proportion of hypertension and diabetes mellitus among groups(all P<0.05).Compared with the normal group,the levels of blood urea nitrogen,serum albumin,serum high density lipoprotein and serum low density lipoprotein in HUA group,CKD group,CKD group and HUA group were higher than those in the normal group,and the proportion of hypertension and diabetes mellitus in CKD accompanied by HUA group was significantly higher than that in CKD group.At the same time,the degree of lipid disorder in CKD accompanied by HUA group was more serious than that in CKD group(all P < 0.05).(2)In groups with different eGFR,there were significant differences in the proportion of male,hypertension and diabetes mellitus among the three groups(all P<0.05).There were significant differences in serum phosphorus,serum total cholesterol,serum triglyceride and serum high density lipoprotein among the three groups(all P<0.05).In addition,in group with eGFR<15.The levels of hemoglobin,erythrocyte count,serum total cholesterol and triglyceride were significantly lower than those of groups with eGFR?60 and 15?eGFR<60(P<0.05),while the levels of serum high density lipoprotein and serum phosphorus were significantly higher than those of the above two groups(P<0.05).In addition,by comparing the body component analysis of groups with different eGFR,it was found that there were significant differences in the above-mentioned indicators among the three groups,including protein,inorganic salt,body fat,body weight,skeletal muscle,body mass parameters,body fat percentage,obesity degree,basal metabolic rate,upper arm circumference,upper arm muscle circumference(all P<0.05);In groups with 15 ? eGFR < 60 and eGFR < 15.The levels of protein,inorganic salt,body weight,skeletal muscle,body mass parameters,basal metabolic rate,upper arm circumference and upper arm muscle circumference in group E were lower than those in group with eGFR?60(all P<0.05),and body fat,body fat percentage and obesitydegree in group with eGFR<15 were lower than those in groups with 15?eGFR<60 and eGFR<15(P<0.05).(3)In groups with different uric acid levels,there were significant differences in the proportion of males,diabetes mellitus,age,alanine aminotransferase,glutamic oxaloacetic transaminase,serum albumin,serum globulin,serum total cholesterol,triglyceride,low density lipoprotein and high density lipoprotein among the three groups(all P<0.05).The proportion of diabetes mellitus in group with HUA?540 was higher than that in groups with HUA<420 and 420?HUA < 540.In addition,in biochemical indicators,the levels of alanine aminotransferase,glutamic oxaloacetic transaminase and serum total cholesterol in group with HUA?540 were significantly higher than those in the other two groups,but the levels of high density lipoprotein were significantly lower than those in the other two groups(P<0.05).(4)Hypertension,diabetes mellitus,AST and total cholesterol were independent risk factors for chronic kidney disease.Serum albumin and high density lipoprotein might be protective factors for chronic kidney disease.(5)The independent risk factors of hyperuricemia included hypertension,diabetes mellitus,total cholesterol,low density lipoprotein,ALT and AST.Conclusion:(1)With the progress of renal function damage,the proportion of hypertension and diabetes mellitus,the degree of lipid disorder,liver enzymes and blood phosphorus levels gradually increase,while serum albumin and body components including protein,inorganic salts,body fat,skeletal muscle,BMI,basal metabolic rate,upper arm circumference and upper arm muscle circumference gradually decrease;(2)With the increase of serum uric acid level.The proportion of hypertension,diabetes mellitus,the degree of lipid disorder and the level of liver enzymes in the population gradually increase;(3)The independent risk factors of chronic kidney disease and hyperuricemia include hypertension,diabetes mellitus and total cholesterol,while serum albumin and high density lipoprotein may be protective factors of chronic kidney disease.