尿酸排泄分数与肾功能关系的研究

Relationship between urinary fractional excretion of uric acid and renal function in patients with chronic kidney disease

关键词:  慢性肾脏病  尿酸排泄分数  肾功能  肾小球滤过率  尿蛋白

Key words:  chronic kidney disease  excretion fraction of uric acid  renal function glomerular filtration rate  urinary protein

摘要:

目的 探讨慢性肾脏病患者中，尿酸排泄分数与肾功能的关系。方法 搜集检测24h尿相关指标的慢性肾脏病患者245例，根据尿酸排泄分数（fraction excretion of uric acid, FEUA）的四分位数间距分为4组（FEUA 1~4），分析尿酸排泄分数与肾功能的关系。运用相关性分析，研究FEUA与预估肾小球滤过率（eGFR）、24h尿蛋白的关系。采用Logistic回归方法分析各临床指标与肾功能的关系。结果 随着FEUA的逐渐升高，eGFR逐渐降低；而且FEUA与eGFR负相关（r=-0.591, P<0.0001）；FEUA与24h尿蛋白正相关（r=0.408，P<0.0001）。Logistic回归表明，FEUA与肾功能相关（OR=1.085，95%CI=1.008~1.167，P=0.035）。结论 在慢性肾脏病患者，FEUA是肾功能的危险因素；而且FEUA水平越高，肾功能越差。

Abstract:

Objective To investigate the relationship between urinary fractional excretion of uric acid (FEUA) and renal function in patients with chronic kidney disease (CKD). Methods Two hundred and forty-five CKD patients were enrolled in the study and 24-h-urine parameters were collected. According to the quartile of FEUA, patients were classified into FEUA 1-4 groups. The relationship between EFUA and estimated glomerular filtration rate (eGFR), and 24h urinary protein were analyzed with Spearman correlation analysis; and the association of renal function with clinical parameters was analyzed with multiple Logistic regression analysis. Results The FEUA level was negatively correlated with eGFR (r=-0.591, P<0.0001) and positively correlated with 24h urinary protein (r=0.408，P<0.0001) in CKD patients. The multiple Logistic regression analysis indicated that FEUA was an independent risk factor for decreased renal function (OR=1.085，95%CI=1.008-1.167, P=0.035). Conclusion Higher urinary fractional excretion of uric acid is associated with a worse renal function in patients with chronic kidney disease.