Hu rau: jerry.he@wecistanche.com

Masoud Mirzaei1, Nader Nourimajalan2* ID, Hamidreza Morovati3 ID, Mohsen Askarishahi4 ID, Roya Hemayati5 ID

1 Yazd Cardiovascular Research Center, Shahid Sadoughi University, Yazd, Iran

2Division of Nephrology, Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Department of Statistics thiab Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

4 Department of Biostatistics, Tsev Kawm Ntawv Kev Noj Qab Haus Huv, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

5Division of Nephrology, Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

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TSAB NTAWV

Taw qhia: ChronicraumKab mob (CKD) yog ib qho teeb meem loj rau kev noj qab haus huv thiab ib qho kev hem thawj rau pej xeem kev noj qab haus huv uas muaj kev pheej hmoo ntau ntxiv thiab lub nra hnyav. Txawm li cas los xij, kev kuaj mob ntxov ntawm tus kab mob no yog qhov nyuaj hauv Iran vim cov ntaub ntawv tsis txaus.

Lub Hom Phiaj: Hauv txoj kev tshawb fawb tam sim no, peb tsom los txiav txim siab txog qhov muaj ntau ntawm CKD thiab nws cov txiaj ntsig zoo hauv lub nroog Yazd, Iran.

Cov neeg mob thiab cov txheej txheem: Peb tau ua qhov kev tshawb fawb hla ntu no siv cov ntaub ntawv nrhiav neeg ua haujlwm ntawm Yazd Health Study (YaHS) khaws cia thaum 2013-2014. Cov ntaub ntawv ntawm 3649 tus neeg, hnub nyoog 20-69 xyoo raug tshuaj xyuas. Glomerular filtration rate (GFR) tau suav nrog kev hloov pauv ntawm kev noj zaub mov hauvlub raumkab mob (MDRD) cov qauv thiab qhov muaj nuj nqis tsawg dua 60 mL / min / 1.73 m' tau txhais tias yog CKD.Logistic regression tau ua haujlwm los txiav txim siab txog qhov pheej hmoo ntawm CKD.

Cov txiaj ntsig: Lub hnub nyoog nruab nrab ntawm cov neeg tuaj koom yog 46.0± 13.8 xyoo thiab tag nrho qhov feem ntau ntawm CKD yog 6.6 feem pua ​​(7.6 feem pua ​​​​rau cov poj niam thiab 5.4 feem pua ​​​​rau cov txiv neej). Cov kab mob kis tau yog 21.5 feem pua ​​​​ntawm cov hnub nyoog ntawm { {12}} xyoo.Qhov tshwm sim ntawm CKD muaj kev sib raug zoo nrog cov hnub nyoog laus dua, rog rog, poj niam txiv neej, ntshav qab zib, ntshav siab thiab keeb kwm ntawm kab mob plawv.

Xaus: CKD muaj qhov muaj neeg coob coob hauv cov pej xeem ntawm thaj av no ntawm Iran. Qhov tseem ceeb tshaj plaws ntawm kev hloov pauv uas muaj feem cuam tshuam rau CKD suav nrog ntshav qab zib thiab ntshav siab. Yog li, txoj kev noj qab haus huv yuav tsum mob siab rau kev tshawb pom ntxov ntawm CKD txhawm rau tiv thaiv kev mob thiab kev tuag ntawm tus kab mob no.

Kev cuam tshuam rau kev noj qab haus huv txoj cai / kev coj ua / kev tshawb fawb / kev kawm kho mob: Hauv kev tshawb fawb pej xeem ntawm 3649 tus neeg koom hauv nruab nrab ntawm Iran, lub nroog Yazd, tag nrho cov kab mob ntev.raumkab mob (CKD) yog 6.6 feem pua. Qhov tseem ceeb tshaj plaws ntawm kev hloov pauv uas muaj feem cuam tshuam rau CKD suav nrog ntshav qab zib thiab ntshav siab. Cov kab ke kev noj qab haus huv yuav tsum mob siab rau kev tshawb pom ntxov ntawm CKD txhawm rau tiv thaiv kev mob thiab kev tuag ntawm CKD, tshwj xeeb tshaj yog nyob rau thaj tsam ntawm Iran. Thov sau cov ntaub ntawv no xws li: Mirzaei M, Nourimajalan N, Morovati H, Askarishahi M, Hemayati R. Prevalence thiab predisposing yam mob ntev.raumkab mob hauv lub nroog Yazd; ib txoj kev tshawb fawb txog pej xeem. J Renal Inj Prev. 2022; 11(1): e01. doi: 10.34172/jrip.2022.01.

Taw qhia

Ntevraumkab mob (CKD) yog ib qho ntawm cov teeb meem kev noj qab haus huv hauv ntiaj teb (1) thiab nws qhov kev nthuav dav tau nce siab hauv cov teb chaws tsim kho (2). Tus kab mob no tau nyob qib 27 ntawm qhov ua rau tuag nyob rau xyoo 1990, tab sis los ntawm 2010, nws nyob rau qib 18 (3). CKD txhais tau tias yog qhov txo qis ntawm glomerular pom lossis tso zis tawm ntawm albumin (4,5). Qhov kev loj hlob ntawm tus kab mob no feem ntau yog mob me thiab asymptomatic mus txog rau thaum kawglub raumkab mob (ESRD).

Nyob rau theem no, kev ua haujlwm ntawmlub raumtxo qis qis dua 15 feem pua ​​thiab tus neeg mob xav taulub raumhloov kho, xws li kev lim ntshav lossisraumtransplantation kom ciaj sia (6). Cov neeg mob ESRD muaj lub neej zoo thiab lub neej expectancy qis dua li cov pej xeem. Tsis tas li ntawd, txo qis ntawmraumkev ua haujlwm ua rau muaj kev pheej hmoo ntawm cov kab mob plawv thiab lawv cov kev tuag muaj feem cuam tshuam (7). Txawm hais tias CKD nce mus dhau lub sijhawm, ua rau muaj teeb meem tshiab thiab ua rau muaj teeb meem yav dhau los, nws txoj kev nce qib yuav raug txo qis thiab kev tswj hwm tus nqi yuav raug zam los ntawm kev kuaj mob ntxov.

Vim qhov kev kuaj mob lig ntawm CKD nyob rau hauv cov teb chaws tsim, feem ntau cov neeg mob raug txheeb xyuas nyob rau theem kawg ntawm tus kab mob. Kev tshawb fawb thoob ntiaj teb txog lub nra ntawm cov kab mob tau pom tias kev tuag los ntawm CKD hauv Iran yog tsawg dua ib feem pua ​​​​hauv xyoo 1990, tab sis tau nce siab dua 2 feem pua ​​​​hauv 2013. Qhov txo qis ntawm GFR kuj tau hais tias yog ib qho ntawm cov laj thawj tseem ceeb ntawm kev tuag. hauv Iran (8). Qhov kev nce ntxiv ntawm tus kab mob no yuav tsum tau ua sai sai thiab thawj kauj ruam yog ntsuas qhov tshwm sim thiab cov qauv ntawm CKD hauv Iran. Txawm hais tias muaj kev tshawb fawb dav dav hauv cov teb chaws tsim, kev tshawb fawb txog kev nthuav dav ntawm CKD thiab nws cov kev txiav txim siab tsis txaus hauv cov teb chaws tsim kho xws li Iran (9). Hauv cov kev tshawb fawb yav dhau los ua nyob rau Iran, qhov kev hloov pauv ntawm qhov tshwm sim ntawm CKD theem III-V hauv qee lub xeev ntawm Iran tau sib txawv thiab dav thiab tau tshaj tawm ntawm 6 thiab 17 feem pua ​​(10). Qhov no qhia txog qhov yuav tsum tau ua qhov kev tshawb fawb no hauv lwm qhov chaw ntawm Iran. Tsis muaj kev tshawb fawb tau tshawb fawb txog kev kis tus kab mob hauv nruab nrab Iran, Yazd. Tshwj xeeb tshaj yog hais tias ntshav qab zib, uas yog ib qho tseem ceeb ua rau CKD, muaj ntau heev nyob rau hauv lub cheeb tsam ntawm Iran (11). Tsis tas li ntawd, kev tshawb fawb pej xeem tsis tshua tau ua hauv Iran. Qhov tsis muaj cov ntaub ntawv yooj yim thiab meej ntawm CKD hauv Iran tiv thaiv kev nkag siab txog lub nra thiab kev kuaj mob ntxov ntawm tus kab mob no. Yog li ntawd, cov kev tshawb fawb zoo ntawm CKD yog xav tau hauv Iran.

Lub hom phiaj

Hauv txoj kev tshawb fawb txog pej xeem no, peb tsom los txiav txim qhov muaj feem ntau ntawm CKD thiab nws cov kev txiav txim siab ntawm 20- 69 xyoo cov pej xeem siv cov ntaub ntawv los ntawm Yazd Health Study (YaHS) cov ntaub ntawv (12).

Cov neeg mob thiab cov txheej txheem

Kawm tsim qauv

Txoj kev tshawb no hla ntu no tau ua los ntawm YaHS cov ntaub ntawv nrhiav neeg ua haujlwm uas tau sau thaum lub sijhawm 2014-15 (12).

Kaum txhiab tus neeg nyob hauv Yazd Greater Cheeb Tsam uas muaj hnub nyoog 20-69 xyoo tau raug xaiv los ntawm pawg random sampling thiab koom nrog YaHS. Cov kws tshawb fawb YaHS tau ua kev xam phaj thiab suav cov kev ntsuas anthropometric (qhov siab, qhov hnyav, lub duav ncig thiab lub duav ncig) thiab ntshav siab raws li cov txheej txheem siv tau. Cov ntsiab lus ntawm YaHS tau tshaj tawm lwm qhov (13). Zuag qhia tag nrho, 40 feem pua ​​​​ntawm cov neeg koom (n=3825) tau pom zoo muab lawv cov ntshav kuaj rau ntau yam kev kuaj rau hauv chav kuaj. Ntawm lawv, 175 tus neeg raug tshem tawm vim lawv tsis muaj cov ntaub ntawv xav tau los suav GFR. Yog li, hauv txoj kev tshawb fawb tam sim no, peb siv cov ntaub ntawv sau los ntawm 3649 tus neeg koom.

Cov ntaub ntawv pej xeem suav nrog hnub nyoog, poj niam txiv neej, theem kev kawm, kev txij nkawm, thiab keeb kwm ntawm kev haus luam yeeb, kab mob plawv, ntshav qab zib thiab ntshav siab tau sau tseg siv daim ntawv nug. Kev kuaj lub cev xws li kev ntsuas anthropometric thiab ntshav siab tau ua los ntawm cov neeg ua haujlwm cob qhia. Lub plab ncig tau ntsuas rau qhov ze tshaj plaws {{0}}.1 cm nrog cov neeg koom nrog hnav khaub ncaws hnav thiab tsis muaj qhov siab ntawm lub cev. Lub duav ncig tau ntsuas ntawm qhov dav tshaj plaws ntawm lub pob tw siv tib txoj kev. Tom qab ntawd, lub duav ncig tau muab faib los ntawm lub duav ncig thiab lub duav-rau-qhov siab (WHR) tau txais. Cov theem kev pheej hmoo raug txhais tias WHR Ntau dua lossis sib npaug rau 0.9 cm hauv cov txiv neej thiab WHR Ntau dua lossis sib npaug rau 0.85 cm hauv cov poj niam (13). Ib daim kab xev ntsuas tau ua haujlwm los ntsuas qhov siab ntawm cov neeg koom hauv cm yam tsis muaj khau, kaus mom, lossis plaub hau clip. Qhov hnyav kuj tau ntsuas siv Omron BF511digital lub cev scan (Omron Inc. Nagoya, Nyiv), nrog qhov tseeb ntawm 0.1 kg. Lub cev qhov ntsuas qhov ntsuas (BMI) tau los ntawm kev faib qhov hnyav hauv kg los ntawm qhov siab squared hauv ' meter '. BMI nyob rau hauv qhov ntau ntawm 25-29.9 kg/m² tau txhais tias rog dhau thiab BMI Ntau dua lossis sib npaug li 30 kg/m² pom tias rog. Tsis tas li ntawd, peb siv tus qauv ntsuas siab los ntsuas cov neeg koom nrog cov ntshav siab tom qab tsib feeb ntawm so hauv qhov chaw zaum. Ntshav siab tau ntsuas peb zaug ntawm sab tes xis ntawm tus neeg nrog tsawg kawg tsib feeb ib ntus; qhov nruab nrab ntawm ob qhov kev ntsuas kawg tau suav thiab txhais tau tias yog tus neeg koom nrog cov ntshav siab. Ntshav siab yog txhais tau tias yog ntshav siab systolic siab dua lossis sib npaug ntawm 140 mm Hg, diastolic ntshav siab ntau dua lossis sib npaug li 90 mm Hg lossis noj cov tshuaj ntshav siab (14).

Tom qab 12 teev ntawm kev yoo mov, 10 mL ntawm cov ntshav venous tau sau los ntawm txhua tus neeg koom nrog. Cov kev sim biochemical suav nrog creatinine, yoo ntshav qabzib, roj cholesterol, qis lipoproteins tsawg (LDL-c), high-density lipoproteins (HDL-c) thiab triglycerides (TG) tau ntsuas siv cov khoom siv enzyme colorimetric (Pars Azmon). Hauv peb qhov kev soj ntsuam, qhov qis HDL-c tau txhais tias tsawg dua 40 mL / dL hauv cov txiv neej thiab tsawg dua 50 mL / dL hauv cov poj niam. Cov tib neeg uas yoo ntshav qab zib ntau dua lossis sib npaug li 126 mL / dL, keeb kwm ntawm ntshav qab zib lossis noj cov tshuaj tiv thaiv kab mob ntshav qab zib tau txhais tias yog cov neeg mob ntshav qab zib. Cov roj (cholesterol) ntau dua lossis sib npaug li 200 mL / dL, triglyceride Ntau dua lossis sib npaug li 150 mL / dL thiab LDL-c Ntau dua lossis sib npaug li 130 mL / dL raug cais raws li siab dua li qub. Cov qib creatinine hauv cov ntshav tau ntsuas raws li Jaffe's kinetic standard method (Pars Azmon). Tsis tas li ntawd, txhawm rau xam qhov kwv yees glomerular filtration rate (eGFR), kev hloov pauv ntawm kev noj zaub mov hauvlub raumkab mob (MDRD) sib npaug tau siv raws li kev pom zoo los ntawm lub teb chaws lub raum lub hauv paus (15,16). Cov mis eGFR yog raws li nram no: GFR hauv mL/min/1.73 m2=175 × SCr−1.154 × hnub nyoog−0.203 × (0.742 yog poj niam)

CovLub raumDisease Outcome Quality Initiative cov txheej txheem txhais tau hais tias CKD theem 1 yog eGFR Ntau dua lossis sib npaug li 90 mL / min / 1.73 m2 nrog cov pov thawj ntawmraumkev puas tsuaj; theem 2, raws li eGFR nyob rau hauv thaj tsam ntawm 60-89 mL/min/1.73 m2 (mob qis hauv GFR); theem 3, raws li eGFR nyob rau hauv thaj tsam ntawm 30-59 mL/min/1.73 m2 (mob qis hauv GFR); theem 4, raws li eGFR nyob rau hauv thaj tsam ntawm 15-29 mL/min/1.73 m2 (qhov hnyav poob hauv GFR); thiab theem 5, eGFR Tsawg dua lossis sib npaug li 15 mL / min / 1.73 m2 (dialysis-dependent;raumua tsis tiav). Hauv txoj kev tshawb no, peb suav tias eGFR Tsawg dua lossis sib npaug li 60 mL / min / 1.73m2 raws li CKD (theem 3 txog 5).

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Cov ntaub ntawv tsom xam

Ntxiv mus, tag nrho cov ntaub ntawv txuas ntxiv nrog kev faib tawm ib txwm raug xam raws li qhov ntsuas ± tus qauv kev sib txawv thiab cov kev sib txawv ntawm cov kev faib tawm tau qhia tias feem pua. Qhov sib txawv ntawm qhov sib txawv tsis tu ncua tau tshawb xyuas siv t-test thiab qhov sib txawv ntawm qhov sib txawv ntawm qhov sib txawv tau tshawb xyuas los ntawm chi-square test. Ib qho qauv sib txawv logistic regression tau siv los ntsuas qhov sib txawv ntawm qhov sib txawv (OR) ntawm cov xwm txheej muaj feem cuam tshuam nrog CKD. Txhua qhov kev txheeb xyuas txheeb cais tau ua los ntawm SPSS version 20 ntawm qhov tseem ceeb ntawm 0.05.

Cov txiaj ntsig

Peb tau kawm tag nrho ntawm 3649 tus neeg mob hauv lub hnub nyoog ntawm 20-69 xyoo nrog lub hnub nyoog nruab nrab ntawm 46.0 ± 13.8 xyoo. Ntawm tag nrho cov pejxeem, 53.7 feem pua ​​(n=1960) ​​yog poj niam. Hais txog BMI, 39 feem pua ​​​​ntawm cov neeg koom tau rog dhau thiab 30 feem pua ​​​​tau rog. Nyob ib ncig ntawm 74.5 feem pua ​​​​ntawm cov neeg koom nrog WHR txawv txav. Nyob rau hauv txoj kev tshawb no, qhov tshwm sim ntawm hom II mob ntshav qab zib mellitus thiab ntshav siab yog 20.1 feem pua ​​thiab 38.9 feem pua. Tsis tas li ntawd, 10.2 feem pua ​​​​ntawm cov neeg mob muaj keeb kwm ntawm kev haus luam yeeb thiab 7.3 feem pua ​​​​tau muaj keeb kwm mob plawv. Qhov nruab nrab ntawm eGFR yog 84.1 ± 17.7 mL / min / 1.73m2 rau cov neeg koom nrog vim cov poj niam (82 mL / min / 1.73 m2) tau qhab nia qis dua li txiv neej (86.0 mL / min / 1.73 m2; P<>

Tag nrho qhov ntau ntawm CKD yog 6.6 feem pua ​​​​raws li eGFR suav nrog MDRD kab zauv, (5.4 feem pua ​​​​ntawm cov txiv neej thiab 7.6 feem pua ​​ntawm cov poj niam). Feem ntau ntawm CKD hauv cov tib neeg muaj thiab tsis muaj ntshav qab zib yog 14.3 feem pua ​​​​thiab 4.7 feem pua ​​​​, feem. Tus nqi CKD hauv cov neeg koom nrog ntshav siab thiab ntshav siab yog 11.8 feem pua ​​thiab 3.3 feem pua. Peb qhov kev tshawb pom tau pom tias 95 feem pua ​​​​ntawm cov neeg mob CKD nyob rau theem peb, 3 feem pua ​​​​nyob rau theem plaub, thiab tsuas yog 2 feem pua ​​(n=5) nyob rau theem tsib. Qhov feem ntau ntawm CKD nce nrog kev laus, yog li qhov muaj feem ntawm CKD ntawm 50-59 cov neeg muaj hnub nyoog yog 21.5 feem pua ​​(26 feem pua ​​​​ntawm cov poj niam thiab 16.8 feem pua ​​ntawm cov txiv neej). Hauv txhua pab pawg hnub nyoog, qhov tshwm sim ntawm CKD yog siab dua rau cov poj niam dua li txiv neej (Table 1).

Lub hnub nyoog nruab nrab ntawm cov neeg koom nrog CKD (59.8 ± 8.6 xyoo) tau siab dua cov neeg noj qab haus huv (45.6 ± 13.6 xyoo; P<0.001). the="" laboratory="" tests="" showed="" that="" the="" means="" of="" fasting="" blood="" sugar,="" serum="" creatinine,="" triglyceride,="" and="" serum="" cholesterol="" were="" significantly="" higher="" in="" ckd="" than="" non-ckd="" persons="">

Hauv kev txheeb xyuas ob qhov sib txawv, cov xwm txheej cuam tshuam nrog CKD yog hnub nyoog, poj niam txiv neej, ntshav qab zib mellitus, ntshav siab, keeb kwm ntawm kab mob plawv, BMI, WHR thiab ntshav HDL-c (Tables 2 thiab 3). Hauv kev txheeb xyuas ntau yam, peb pom muaj kev sib raug zoo ntawm CKD thiab qhov sib txawv ntawm hnub nyoog, poj niam txiv neej, rog, keeb kwm ntawm kab mob plawv, ntshav qab zib thiab ntshav siab (Table 4). Hauv pawg hnub nyoog ntawm 20-49 xyoo, tsuas yog ntshav siab tau cuam tshuam nrog CKD (P=0.004).

Peb pom tias cov poj niam muaj li 49 feem pua ​​​​kev pheej hmoo siab dua (LOSSIS=1.49, 95 feem pua ​​CI=1.10–2.02) ntawm muaj CKD ntau dua li txiv neej. Ib qho kev sib koom ua ke kuj tau pom ntawm hnub nyoog thiab CKD. Hauv lwm lo lus, qhov txawv ntawm kev tsim CKD rau cov hnub nyoog ntawm 40-59 thiab 60-69 xyoo yog kwv yees li 4.23 (95 feem pua ​​​​CI=1.90–9.44) thiab 25.04 (95 feem pua ​​CI { {20}}.33–55.34), feem, piv nrog qhov txawv ntawm 20-39 pawg hnub nyoog. Qhov kev pheej hmoo ntawm CKD yog kwv yees li 1.9 (95 feem pua ​​​​CI=1.3–2.8) ntau dua rau cov neeg rog rog piv nrog cov neeg uas muaj BMI <25 kg/m2="" .="" qhov="" kev="" pheej="" hmoo="" ntawm="" ckd="" yog="" kwv="" yees="" li="" 1.46="" (95="" feem="" pua="" ​​​​ci="1.08–1.97)" lub="" sijhawm="" siab="" dua="" hauv="" cov="" neeg="" koom="" nrog="" ntshav="" qab="" zib="" piv="" nrog="" cov="" neeg="" tsis="" muaj="" ntshav="" qab="" zib.="" qhov="" kev="" pheej="" hmoo="" ntawm="" ckd="" yog="" kwv="" yees="" li="" 1.53="" (95="" feem="" pua="" ​​​​ci="1.11–2.10)" lub="" sij="" hawm="" siab="" dua="" rau="" cov="" neeg="" mob="" ntshav="" siab="" dua="" li="" cov="" neeg="" tsis="" muaj="" ntshav="" siab.="" qhov="" kev="" pheej="" hmoo="" ntawm="" ckd="" yog="" kwv="" yees="" li="" 1.87="" (95="" feem="" pua="" ​​​​ci="1.28–" 2.72)="" lub="" sij="" hawm="" siab="" dua="" hauv="" cov="" neeg="" mob="" uas="" muaj="" keeb="" kwm="" ntawm="" cvd="" mob="" stroke="" piv="" nrog="" cov="" tsis="" muaj="" keeb="">

Kev sib tham

Txoj kev tshawb no qhia tau hais tias qhov tshwm sim ntawm CKD yog 6.6 feem pua ​​​​ntawm cov neeg nyob rau hauv lub hnub nyoog ntawm 20-69 xyoo nyob rau hauv Yazd Greater Area; 5.4 feem pua ​​ntawm cov txiv neej thiab 7.6 feem pua ​​ntawm cov poj niam. Tsis tas li ntawd, qhov tshwm sim ntawm CKD ntawm 50-59 cov neeg muaj hnub nyoog yog 21.5 feem pua. Lub nroog Yazd nyob hauv thaj tsam nruab nrab ntawm Iran. Piv nrog rau lwm lub xeev ntawm Iran, nws zoo li tias qhov tshwm sim ntawm tus kab mob no hauv Yazd muaj qee qhov sib txawv thiab zoo sib xws nrog lwm thaj chaw ntawm Iran.

Nws tau raug tshaj tawm tias qhov ntau ntawm CKD txawv heev hauv kev tshawb fawb hauv Iran. Qhov qis tshaj plaws ntawm CKD yog nyob rau hauv lub xeev Golestan, uas yog 4.6 feem pua ​​(17) thiab qhov ntau tshaj plaws nyob rau hauv Urmia uas yog.

Table 1. Feem ntau ntawm CKD ntawm cov hnub nyoog sib txawv thiab poj niam txiv neej ntawm cov neeg nyob hauv Yazd Greater Area hnub nyoog 20-69 xyoo

37.9 feem pua ​​(18). Qee qhov tshwm sim ntawm qhov sib txawv ntawm cov txiaj ntsig no yog qhov sib txawv ntawm txoj kev ntsuas cov ntshav creatinine, qhov sib txawv ntawm txoj kev txiav txim siab GFR, kev hloov pauv hauv cov neeg,

Table 4. Kev txheeb xyuas ntau yam logistic regression ntawm kev kwv yees ntawm CKD

ntau haiv neeg thiab haiv neeg thiab muaj hnub nyoog sib txawv. Hauv peb txoj kev tshawb fawb, tus qauv qauv yog cov pej xeem raws li hnub nyoog tshaj 20 xyoo thiab peb siv MDRD cov qauv los ntsuasraummuaj nuj nqi. Tsis tas li ntawd, cov ntsiab lus ntawm CKD yog GFR Tsawg dua lossis sib npaug li 60 mL / min / 1.73 m2 . Yog li, peb txiav txim siab los sib piv cov txiaj ntsig ntawm peb txoj kev tshawb fawb nrog cov kev tshawb fawb uas, zoo li peb, yog cov pej xeem raws li cov hnub nyoog thiab tseem siv txoj kev MDRD los txiav txim siab GFR thiab cov ntsiab lus ntawm CKD raws li GFR tsawg dua 60 mL / min / 1.73 m2. . Plaub tus yam ntxwv no tau hais hauv txoj kev tshawb fawb tau pom hauv cov kev tshawb fawb hauv Golestan, Fars thiab Tehran xeev (10,17,19,20).

Khajehdehi et al suav txog qhov tshwm sim ntawm CKD hauv xeev Fars thiab qhia tias tag nrho cov kab mob ntawm cov neeg muaj hnub nyoog tshaj 18 xyoo yog 11.6 feem pua ​​(14.9 feem pua ​​​​ntawm cov poj niam thiab 4.5 feem pua ​​​​ntawm cov txiv neej) thiab rau cov hnub nyoog 60 xyoo yog 31 feem pua ​​(19). Hauv lub nroog Gonabad, Naghibi thiab al tau tshaj tawm tias qhov tshwm sim ntawm CKD hauv cov tib neeg hnub nyoog 20-60 xyoo yog 5.1 feem pua ​​(20). Najafi thiab al tau tshaj tawm txog qhov muaj ntau ntawm 4.6 feem pua ​​​​rau CKD raws li GFR ntawm cov neeg laus Ntau dua lossis sib npaug rau 18 xyoo hauv Golestan (17). Safari Nejad et al tau ua tiav kev tshawb fawb txog pej xeem ntawm 17 txhiab tus neeg muaj hnub nyoog tshaj 14 xyoo hauv Iran thaum lub sijhawm 2002- 2005 thiab tshaj tawm tias feem ntau ntawm CKD yog 7.8 feem pua ​​(10). Tsis tas li ntawd, hauv peb txoj kev tshawb fawb, qhov tshwm sim ntawm CKD yog 6.6 feem pua. Raws li cov kev tshawb fawb saum toj no, uas yog raws li cov pej xeem thiab cov qauv loj ntawm ntau tshaj ib txhiab thiab cov txheej txheem tsim nyog raws li CKD txhais thiab suav nrog GFR, qhov ntau ntawm CKD hauv Iran yog nyob nruab nrab ntawm 4.6 thiab 11.6 feem pua. Qhov sib txawv no tseem tuaj yeem cuam tshuam txog kev sib txawv ntawm caj ces, qhov sib txawv ntawm cov ntshav qab zib thiab kub siab, uas yog qhov tseem ceeb ntawm CKD.

Hauv peb txoj kev tshawb fawb, qhov tshwm sim ntawm CKD hauv cov hnub nyoog laus yog ntau dua li ntawm pawg hnub nyoog yau; qhov kev pheej hmoo ntawm tus kab mob hauv cov hnub nyoog ntawm 69-60 xyoo yog kwv yees li 25 npaug ntau dua li ntawm cov hnub nyoog 20-39 xyoo. Tsis tas li ntawd, Sepanlou et al kwv yees qhov muaj tus kab mob nyob rau hauv pawg hnub nyoog ntawm 40-75 xyoo li 23.7 feem pua ​​(26.6 feem pua ​​ntawm cov poj niam thiab 20.6 feem pua ​​ntawm cov txiv neej) (9).

Hauv kev txheeb xyuas qhov tsis sib xws, feem ntau ntawm cov kev tshawb fawb tau cuam tshuam nrog CKD. Txawm li cas los xij, nyob rau hauv ntau tus qauv regression, poj niam txiv neej, hnub nyoog laus, ntshav siab, ntshav qab zib thiab keeb kwm ntawm kab mob plawv yog qhov tseem ceeb tshaj plaws uas muaj feem cuam tshuam nrog CKD. Hauv kev txheeb xyuas ntau yam, peb pom tias CKD tsis muaj kev sib raug zoo nrog WHR thiab cov ntshav lipids (triglyceride, HDL-c, LDL-c, thiab cov roj cholesterol).

Hauv kev tshawb fawb feem ntau, txoj hauv kev ntawm CKD yog siab dua rau cov poj niam dua li txiv neej (21,22). Peb kuj pom tias qhov kev pheej hmoo ntawm CKD hauv cov poj niam yog 1.49 npaug ntau dua li cov txiv neej. Feem ntau cov kev tshawb fawb tau tshaj tawm tias ntshav qab zib thiab ntshav siab nce txoj hauv kev tsim CKD (8,19,23). Hauv qhov no, peb pom tias 43 feem pua ​​​​ntawm peb cov pej xeem muaj ntshav qab zib thiab 70 feem pua ​​​​tau muaj ntshav siab, uas lees paub qhov kev tshawb pom yav dhau los. Qhov kev pheej hmoo ntawm CKD yog siab dua hauv cov neeg mob ntshav qab zib thiab cov ntshav siab ntau dua li cov neeg noj qab haus huv.

Cov kev tshawb fawb yav dhau los kuaj pom, muaj kev sib raug zoo ntawm keeb kwm ntawm kab mob plawv thiab CKD (9,22). Hauv peb txoj kev tshawb fawb, qhov kev sib raug zoo no tseem ceeb heev thiab kev pheej hmoo ntawm CKD hauv cov neeg mob uas muaj kab mob plawv yog 1.87 npaug ntau dua li cov neeg koom nrog noj qab haus huv.

As reported in most ofthe previous studies, BMI is one of the major risk factors ofCKD (19,24). Obesity and high BMI can increase the risk of developing CKD (9). In our study, the risk of developing CKD was 1.7 times higher in obese (BMI>30 kg / m²) cov neeg koom nrog ntau dua cov neeg uas muaj BMI Tsawg dua lossis sib npaug li 25 kg / m².

Xaus

CKD muaj ntau qhov kev nthuav dav hauv cov pej xeem ntawm thaj av no ntawm Iran. Xav txog qhov kev loj hlob ntawm kev laus thiab kev pheej hmoo ntawm CKD xws li ntshav qab zib thiab ntshav siab hauv Yazd, CKD yuav ua rau muaj txiaj ntsig zoo rau kev noj qab haus huv thiab kev siv nyiaj ntawm kev noj qab haus huv. Tsis tas li ntawd, txoj kev noj qab haus huv yuav tsum mob siab rau kev tshawb pom ntxov ntawm CKD txhawm rau tiv thaiv kev mob thiab kev tuag ntawm tus kab mob no.

Kev txwv ntawm kev kawm

Hauv peb txoj kev tshawb fawb txog pej xeem, peb tau siv cov qauv tsim nyog loj. Ntxiv mus, cov txheej txheem ntawm kev sau cov ntaub ntawv thiab kev sim kuaj tau raug siv. Txawm li cas los xij, peb tau ntsib ntau yam kev txwv; (a) peb txheeb xyuas cov ntaub ntawv hla ntu ntu, (b) peb ntsuas cov ntshav creatinine ib zaug xwb; qhov zoo tshaj plaws peb tuaj yeem rov ntsuas qhov ntsuas peb lub hlis tom qab thiab (c) peb tsis tau sau cov ntaub ntawv ntsig txog cov zis albumin thiab protein excretion; Yog li ntawd, qhov tshwm sim ntawm CKD theem 1 thiab 2 tsis tuaj yeem kwv yees hauv cov neeg no.

Kev lees paub

Txoj kev tshawb no yog nyiaj txiag los ntawm pawg tshawb fawb ntawm Shahid Sadoughi University of Medical Sciences hauv Yazd. Peb ua tsaug rau txhua tus uas tau koom nrog hauv Yazd Health Study (YaHS).

Cov neeg sau ntawv koom tes

NN, MM thiab HM yog cov kws tshawb fawb tseem ceeb ntawm txoj kev tshawb no. NN, MM thiab HM tau suav nrog hauv kev npaj lub tswv yim thiab tsim qauv. NN thiab MM rov mus saib cov ntawv sau thiab tshuaj xyuas cov ntsiab lus kev txawj ntse. Txhua tus kws sau ntawv tau koom nrog hauv kev npaj cov ntawv kawg ntawm cov ntawv sau, kho cov ntawv sau thiab tshuaj xyuas cov ntsiab lus kev txawj ntse. Txhua tus kws sau ntawv tau nyeem thiab pom zoo cov ntsiab lus ntawm cov ntawv sau thiab lees paub qhov tseeb lossis kev ncaj ncees ntawm ib feem ntawm txoj haujlwm.

Kev tsis sib haum xeeb

Cov kws sau ntawv tshaj tawm tsis muaj kev sib tw nyiam.

Teeb meem kev ncaj ncees

Cov kev tshawb fawb tau ua raws li cov ntsiab lus ntawm Kev Tshaj Tawm ntawm Helsinki. Pawg Tshawb Fawb ntawm Shahid Sadoughi University of Medical Sciences tau pom zoo thiab tau txais nyiaj rau YaHS nrog tus lej lej ntawm 70421 rau 2 Lub Xya Hli 2014. Qhov kev tshawb fawb no kuj tau pom zoo los ntawm Pawg Saib Xyuas Kev Ncaj Ncees ntawm University Research Council nrog tus lej lej ntawm 17/1/73941. Thaum Lub Xya Hli 8, 2014. Tsis tas li ntawd, cov teeb meem kev coj ncaj ncees (xws li kev ua txhaum cai, kev tsim cov ntaub ntawv, kev tshaj tawm ob npaug) tau raug saib xyuas los ntawm cov kws sau ntawv.

Nyiaj txiag/Kev pab

Txoj kev tshawb no yog nyiaj txiag los ntawm pawg tshawb fawb ntawm Shahid Sadoughi University of Medical Sciences hauv Yazd.