Analysis Of Related Factors Of Renal Anemia In Patients With Chronic Kidney Disease 3-5(Non-dialysis) And The Distribution Of TCM Syndromes

Objective: To study the general information,chronic glomerular filtration rate(GFR),laboratory indicators of chronic kidney disease(CKD)stage 3-5 nondialysis patients and renal anemia(RA),Explore the factors that affect renal anemia in patients with CKD3-5,and analyze the distribution pattern of TCM syndromes in CKD renal anemia.It aims to improve the quality of life of patients.Methods: Patients with stage CKD3-5 who were hospitalized in the Hospital from February 1,2018 to November 31,2019 were collected,and a total of 198 patients were included according to the inclusion and exclusion criteria.Record the basic information of the patients and relevant laboratory indicators,and use the TCM four-diagnosis combined parameters to classify the patients.The data was established into a database,and the data was analyzed statistically using SPSS25.0 software.Results:1.198 cases of CKD3-5 patients in terms of the primary disease,chronic glomerulonephritis is the main cause of the disease,followed by diabetic nephropathy.The prevalence of CKD3-5 anemia was 51.7%,82.4%,and 94.4%,respectively.The incidence of anemia continued to increase with the decline of renal function,and the incidence of anemia increased with age.2.The age,BMI,GFR,Scr,BUN,Ca,P,TG,PTH,ALB,24-PRO,SI,TIBC were significantly different between the anemia group and the non-aneemia group;the anemia group had higher age,Scr,BUN,P,PTH,and lower BMI,Ca,TG,ALB,SI,TIBC than the non-anemic group.The difference was statistically significant.The correlation of Hb level with CKD staging,BMI,GFR,Scr,BUN,Ca,P,TG,PTH,ALB,24-PRO,SI,TIBC and other indicators is statistically significant;P,PTH,24-PRO were negatively correlated,and positively correlated with BMI,GFR,Ca,TG,ALB,SI,TIBC.3.GFR,ALB,SI,TIBC are the risk factors of anemia in CKD3-5 patients.Among them,low serum iron level is a risk factor for anemia in patients with CKD3 and CKD4,and low total iron binding capacity is a risk factor for anemia induced by CKD5 patients.4.In patients with CKD3-5,the main cases are mild and moderate anemia.The age,GFR,Scr,BUN,Ca,P,TG,HDL-C,PTH,ALB,24-PRO,SI,TIBC of different anemia levels are significantly different between groups.The correlation between different severity of anemia in patients with CKD3-5 and GFR,Scr,BUN,Ca,P,TG,HDL-C,PTH,ALB,24-PRO and other indicators is statistically significant,and it is correlated with Scr,BUN,P,PTH and 24-PRO were positively correlated and negatively correlated with GFR,Ca,TG,HDL-C and ALB.GFR,ALB reduction and PTH increase are the risk factors of anemia in patients with CKD3-5.5.In CKD patients,the main deficiency syndromes are spleen and kidney qi deficiency syndromes,followed by spleen and kidney yang deficiency syndromes and yin and yang deficiency syndromes.The distribution of this deficiency syndrome in each stage of CKD is that CKD3-4 mainly consists of spleen and kidney qi deficiency syndrome,followed by spleen and kidney yang deficiency syndrome;CKD5 patients mainly spleen and kidney yang deficiency syndrome,followed by yin and yang syndrome deficiency syndrome;spleen and kidney yang deficiency syndrome and yin and yang deficiency syndrome in CKD stage 5patients are significantly increased compared with CKD stage 3-4 patients.The main empirical evidence is mainly the damp turbidity syndrome and the blood stasis syndrome,followed by drowning syndrome,and the dampness-heat syndrome is the least.CKD3 is mainly based on wet turbidity syndrome,followed by blood stasis syndrome;CKD4 is mainly based on blood stasis syndrome,followed by wet turbidity syndrome;CKD5 phase is mainly based on blood stasis syndrome and drowning syndrome.With the continuous decline of renal function,the syndrome of drowning disease continues to increase,the syndrome of dampness and turbidity continues to decrease,and the growth of drunk disease in CKD5 is the most obvious.The distribution of the syndrome of this deficiency syndrome is related to the occurrence of anemia.The mainly consists of spleen and kidney yang deficiency syndrome,followed by spleen and kidney qi deficiency syndrome.There is no correlation between the distribution of standard empirical evidence and the occurrence of anemia.6.Among the patients with mild anemia,the most common types of deficiency syndrome are spleen and kidney qi deficiency syndrome,followed by spleen and kidney yang deficiency syndrome and yin and yang deficiency syndrome;moderate anemia patients with spleen and kidney yang deficiency syndrome are most,followed by liver and kidney yindeficiency syndrome Qi and yin deficiency syndromes;patients with severe anemia are mainly due to spleen and kidney yang deficiency and yin and yang deficiency syndromes.The distribution of standard empirical syndromes in patients with mild anemia is mainly wet and turbid syndrome,followed by blood stasis syndrome,damp heat syndrome,and drowning syndrome;moderate anemia patients are mainly based on blood stasis syndrome,others are wet turbid syndrome,drowning Toxic syndrome,damp heat syndrome;severe anemia patients are mainly drunk.With the gradual increase of anemia,the proportion of drowning is rising.Conclusions:1.The incidence of anemia in non-dialysis patients with stage CKD3-5 continues to increase as renal function declines,and increases with age.The occurrence of anemia is related to age,BMI,GFR,Scr,BUN,Ca,P,TG,PTH,ALB,24-PRO,SI,TIBC indicators.2.In patients with CKD3-5,the main cases are mild and moderate anemia.And with the continuous progress of CKD,the degree of anemia in CKD patients continues to increase.Different degrees of anemia in CKD patients are related to GFR,Scr,BUN,Ca,P,TG,HDL-C,PTH,ALB,24-PRO,SI,TIBC and other indicators.3.Reduced GFR,ALB,SI,TIBC are the risk factors for anemia in patients with CKD3-5.Decrease in GFR,ALB and increase of PTH are the risk factors for increasing the degree of anemia in patients with CKD3-5.4.The TCM syndrome types of CKD patients are divided into this deficiency syndrome and standard syndrome.In this deficiency syndrome,spleen and kidney yang deficiency and spleen and kidney qi deficiency syndrome are more prone to anemia,and CKD patients with spleen and kidney yang deficiency and yin and yang deficiency syndrome are more anaemic.The CKD patients with blood stasis syndrome and drowning syndrome in the standard empirical syndrome are more anaemic.With the gradual increase of anemia,the proportion of drowning is rising.