关键词: 肾功能进展, 病例对照研究, 影响因素分析

Abstract: Objective　To analyze the risk factors for progression of renal function in people receiving physical examination，so as to provide a basis for delaying the decline in renal function and improve quality of life.Methods　People who had more than four consecutive physical examinations in Xuzhou Central Hospital from 2005 to 2012 were enrolled in this study.Thirty-seven patients （154 times） with progression of renal function who had decreased eGFR were selected as the case group，and 111 people （447 times） in the same gender，similar age and without eGFR decline as the control group.Gender，age，systolic blood pressure （SBP），diastolic blood pressure （DBP），pulse pressure （PP），serum creatinine （Scr），urea nitrogen，fasting blood glucose （FPG），triacylglycerol （TG），total cholesterol （TC），high density lipoprotein cholesterol （HDL-C），low density lipoprotein cholesterol （LDL-C），plasma viscosity （PV），body mass index （BMI） and other indicators were compared between the two group.Risk factors for progression of renal function were analyzed by multivariate Logistic regression analysis.The proportion of renal function decline in different blood pressure grades was compared by chi-square test.Results　 There were no statistical differences in age，gender，baseline eGFR，Scr，and urea nitrogen between the two groups （P>0.05）.The 8-year average eGFR was significantly lower than control group，the 8-year average Scr and urea nitrogen in the case group was significantly higher than those in the control group（P<0.05）.There were no statistical differences between the two groups regarding PP，FPG，TG，TC，LDL-C and PV （P>0.05）.The SBP，DBP and BMI in the case group were significantly higher than those in the control group （P<0.05）.The HDL-C in the case group was significantly lower than in the control group（P<0.05）.DBP was an independent factor of decreased eGFR in three models of multivariate analysis，〔model 1：OR=1.027，95%CI（1.011，1.044），P<0.05；model 2：OR=1.028，95%CI（1.004，1.053），P<0.05；model 3：OR=1.027，95%CI（1.003，1.052），P<0.05〕，and other factors were not statistically significant in the multiple factors analysis.As the level of hypertension elevated，the proportion of decline in renal function increased（χ2 Linear-by-Linear Association =10.312，P=0.001）.Conclusion　 In this study，we find the DBP is an independent risk factor for progression of renal function.Healthy people should maintain good living habits and DBP to delay renal progression.

Key words: Progression of renal function, Case-control study, Root cause analysis