Abstract: Objective　To investigate the prevalence and risk factors of chronic kidney disease （CKD） among residents from Pudong New Area,Shanghai.Methods　Based on the former study in 2008,10 657 permanent residents in Pudong New Area who met inclusion criteria,were selected as study subjects by multistage sampling in 2013.The contents of investigation included residents’ basic information such as gender,age,education level,sitting time,sleeping time，status of physical activities,diabetes,hypertension,dyslipidemia,central obesity,and hyperuricemia.Physical and biochemical examination were also used in this study.The prevalence of albuminuria,leucocyturia,haematuria,reduced renal function and CKD were calculated.CKD definition included kidney injury （albuminuria,leucocyturia,haematuria）,or reduced renal function〔eGFR <60 ml·min-1·（1.73 m2）-1〕,or self-reported clinical diagnosis.The standardized prevalence was adjusted according to national population composition 2010.Multiple Logistic regression analysis was used to analyze the risk factors of CKD prevalence.Results　9 653 respondents had information about the ending of CKD among 10 657 respondents.Among 9 653 efficient respondents,3 550 （36.78%） were male and 6 103 （63.22%） were female.There were significant differences in age,education level,sitting time,sleeping time,physical activities,prevalence of diabetes,hypertension,dyslipidemia,central obesity and hyperuricemia between males and females（P<0.05）.The prevalence and the standardized prevalence of albuminuria was 12.10% （867/7 164） and 9.22%,respectively.There was no significant difference in prevalence of albuminuria among groups with different gender,sleeping time,and status of physical activities （P>0.05）.There were significant differences in prevalence of albuminuria among groups with different age,education level,sitting time,status of diabetes,hypertension,dyslipidemia,central obesity and hyperuricemia （P<0.05）.The prevalence of albuminuria increased with increased age（χ2trend=73.112,P<0.05） and decreased with increased education level（χ2trend=60.559,P<0.05）.The prevalence and the standardized prevalence of leucocyturia was 8.48% （482/5 684） and 6.21%,respectively.There were significant differences in prevalence of leucocyturia among groups with different gender,age,education level,sitting time,status of hyperuricemia （P<0.05）.The prevalence of leucocyturia increased with increased age in females（χ2trend=14.769,P<0.05）,while this tendency was not observed in males（χ2trend=3.257,P=0.071）.The prevalence of leucocyturia decreased with increased education level （χ2trend=17.272,P<0.05）.The prevalence and the standardized prevalence of haematuria was 11.89% （711/5 979） and 10.27%,respectively.There were significant differences in prevalence of haematuria among groups with different gender,age,education level and sleeping time （P<0.05）.The prevalence of haematuria increased with increased age in males （χ2trend=37.939,P<0.05）,while this tendency was not observed in females （χ2trend,P=0.199）.The prevalence of haematuria decreased with increased education level（χ2trend=8.685,P<0.05）.The prevalence and the standardrized prevalence of reduced renal function was 1.40% （135/9 619） and 0.80%,respectively.There were significant differences in prevalence of reduced renal function among groups with different age,education level,sitting time,status of diabetes,hypertension,dyslipidemia,central obesity and hyperuricemia （P<0.05）.The prevalence of reduced renal function increased with increased age （χ2trend=108.479,P<0.05） and decreased with increased education level （χ2trend=23.961,P<0.05）.The prevalence and the standardized prevalence of CKD was 19.88% （1 919/9 653） and 15.65%,respectively.There was no significant difference in prevalence of CKD among groups with different sitting time and status of physical activities （P>0.05）.There were significant differences in prevalence of CKD among groups with different gender,age,education level,sleeping time,status of diabetes,hypertension,dyslipidemia,central obesity and hyperuricemia （P<0.05）.The prevalence of CKD increased with increased age both in males and females（χ2trend in males and females was 86.465 and 53.838,P<0.05） and decreased with increased education level （χ2trend=65.358,P<0.05）.According to multiple Logistic regression analysis results,factors associated with CKD included gender,age,status of hypertension,diabetes,dyslipidemia and hyperuricemia （P<0.05）.Conclusion　The prevalence of CKD in Pudong New Area of Shanghai is high and CKD is becoming a public health problem.Gender,age,status of hypertension,diabetes mellitus,dyslipidemia and hyperuricemia are factors associated with CKD.In order to restraint the progress of CKD and reduce the medical burden of individuals and society,early prevention and treatment of CKD should be paid attention to.

Key words: Nephrosis, Prevalence, Risk factors, Cross-sectional studies, Epidemiology, Shanghai

摘要： 目的　调查上海市浦东新区居民慢性肾病（CKD）患病情况，并探究CKD的危险因素。方法　在本课题组前期研究（2008年上海市浦东新区横断面调查人群）的基础上，以相同的多阶段抽样方法，抽取2013年浦东新区符合纳入标准的常住居民10 657例为调查对象。调查内容包括社区居民基本情况（性别、年龄、文化程度、静坐时间、睡眠时间、体育活动、糖尿病、高血压、血脂异常、向心性肥胖、高尿酸血症）；并对居民进行体格检查，记录其清蛋白尿、白细胞尿、肾功能下降、血尿、CKD患病率，其中肾损伤（清蛋白尿、白细胞尿、血尿）或肾功能下降〔估算肾小球滤过率（eGFR）<60 ml·min-1·（1.73 m2）-1〕或自报临床明确诊断中任意一项阳性均定义为CKD。以2010年全国人口构成对居民患病率进行标化。采用多因素Logistic回归分析分析居民患CKD的影响因素。结果　10 657例调查对象中最终能够获得CKD结局的有效调查人数为9 653例，其中男3 550例（36.78%），女6 103例（63.22%）。不同性别居民年龄、文化程度、静坐时间、睡眠时间、是否参加体育活动、糖尿病发生率、高血压发生率、血脂异常发生率、向心性肥胖发生率、高尿酸血症发生率比较，差异均有统计学意义（P<0.05）。居民清蛋白尿患病率为12.10%（867/7 164），全国人口标化患病化为9.22%。不同性别、睡眠时间及是否参加体育活动居民的清蛋白尿患病率比较，差异无统计学意义（P>0.05）。不同年龄、文化程度、静坐时间，是否存在糖尿病、高血压、血脂异常、向心性肥胖、高尿酸血症居民的清蛋白尿患病率比较，差异有统计学意义（P<0.05）。居民清蛋白尿患病率有随年龄增加而逐渐上升的趋势（χ2趋势=73.112，P<0.05）；居民清蛋白尿患病率有随文化程度升高而逐渐降低的趋势（χ2趋势=60.559，P<0.05）。居民白细胞尿患病率为8.48%（482/5 684），全国人口标化患病化为6.21%。不同性别、年龄、文化程度、静坐时间，是否存在高尿酸血症居民的白细胞尿患病率比较，差异有统计学意义（P<0.05）。女性白细胞尿患病率随年龄增加而升高（χ2趋势=14.769，P<0.05）；男性白细胞尿患病率无年龄趋势（χ2趋势=3.257，P=0.071）。居民白细胞尿患病率有随文化程度升高而逐渐降低的趋势（χ2趋势=17.272，P<0.05）。居民血尿患病率为11.89%（711/5 979），全国人口标化患病化为10.27%。不同性别、年龄、文化程度、睡眠时间居民的血尿患病率比较，差异有统计学意义（P<0.05）。男性血尿患病率随年龄增加而升高（χ2趋势=37.939，P<0.05），女性患病率无年龄趋势（χ2趋势=1.649，P=0.199）。居民血尿患病率有随文化程度升高而逐渐降低的趋势（χ2趋势=8.685，P<0.05）。居民肾功能下降患病率为1.40%（135/9619），全国人口标化患病化为0.80%。不同年龄、文化程度、静坐时间、是否存在糖尿病、高血压、血脂异常、向心性肥胖、高尿酸血症居民的肾功能低下患病率比较，差异有统计学意义（P<0.05）。居民肾功能下降患病率有随年龄增加而逐渐上升的趋势（χ2趋势=108.479，P<0.05）。居民肾功能下降患病率有随文化程度升高而逐渐降低的趋势（χ2趋势=23.961，P<0.05）。居民CKD患病率为19.88%（1 919/9 653），全国人口标化患病率为15.65%。不同静坐时间、是否参加体育活动居民的CKD患病率比较，差异无统计学意义（P>0.05）；不同性别、年龄、文化程度、睡眠时间，是否存在糖尿病、高血压、血脂异常、向心性肥胖、高尿酸血症居民的CKD患病率比较，差异有统计学意义（P<0.05）。男性、女性CKD患病率均有随年龄增加而逐渐上升的趋势（χ2趋势分别为86.465、53.838，P<0.05）；居民CKD患病率有随文化程度升高而逐渐降低的趋势（χ2趋势=65.358，P<0.05）。多因素Logistic回归分析结果显示，性别、年龄、是否存在糖尿病、高血压、血脂异常、高尿酸血症是CKD的影响因素（P<0.05）。结论　浦东新区常住居民CKD患病率较高，已成为浦东新区重要的公共卫生问题之一，且性别、年龄，是否存在糖尿病、高血压、血脂异常、高尿酸血症是CKD的影响因素，因此需重视CKD的早期防治，遏制CKD进展，减轻个人及社会的医疗负担。

关键词: 肾病, 患病率, 危险因素, 横断面研究, 流行病学, 上海