【摘要】：目的：研究健康老年人生理性腎功能減退與相應(yīng)eGFR水平的糖尿病腎臟病及高血壓腎病患者肌酐、鈣、鉀、尿酸等物質(zhì)排泄情況的差異。 方法：選取2012年-2013年山東省青島市立醫(yī)院腎內(nèi)科以糖尿病及高血壓病為原發(fā)病的CKD早期(12期)病人(CKD早期病人),正常老年組選取查體后篩選無腎臟病的70歲以上老年人,分別檢測(cè)空腹血清中肌酐、尿酸、鈣、鉀,晨尿中肌酐、尿酸、鈣、鉀含量,計(jì)算eGFR及各物質(zhì)排泄分?jǐn)?shù)(FE),進(jìn)行對(duì)比。 結(jié)果：將三組病人血清各物質(zhì)濃度進(jìn)行對(duì)比,如表2顯示,三組病人血清TG,TC,LDL,血糖水平相當(dāng),無統(tǒng)計(jì)學(xué)差異(p0.05), CKD早期病人較大于70歲健康老年人血肌酐有顯著差異(p0.01),但三組病人eGFR相當(dāng),無統(tǒng)計(jì)學(xué)差異(P0.05)。健康老年人血清尿酸較CKD早期病人低,血清胱抑素C,血鈣水平較CKD早期病人水平高,有顯著性差異(p0.01,p0.01, p0.01),三組病人血清鈉無明顯差異(p0.05)。CKD早期病人與健康老年人各物質(zhì)排泄率比較,表3顯示,FENa, FEC1升高,均有統(tǒng)計(jì)學(xué)意義(P0.05, P0.05)。FEK, FECa, FEUA無明顯差異(p0.05, p0.05, p0.05)。 結(jié)論： 1.70歲以上健康老年人與以糖尿病及高血壓病為原發(fā)病的早期CKD病人腎小球?yàn)V過率相當(dāng),但物質(zhì)排泄存在差異,兩者為不同的病理生理狀態(tài),臨床上需區(qū)別對(duì)待。 2.同時(shí)平均年齡75歲的健康老年人腎臟功能處于CKD1-2期,而非先前認(rèn)定的CKD3期。 3.對(duì)于高齡老年人,GFR的不同評(píng)估公式存在一定的差別,需要進(jìn)一步的研究明確。
[Abstract]:Objective: to study the difference of creatinine, calcium, potassium and uric acid excretion between healthy elderly patients with physiological renal dysfunction and diabetic kidney disease and hypertensive nephropathy with corresponding eGFR level. Methods: from 2012 to 2013, early CKD patients (early CKD patients) with diabetes mellitus and hypertension as the primary disease in the Department of Nephrology, Qingdao Municipal Hospital of Shandong Province were selected. In the normal elderly group, the contents of serum creatinine, uric acid, calcium and potassium in fasting serum, creatine, uric acid, calcium and potassium in morning urine were measured after physical examination, and the excretion fraction of eGFR and (FE), were calculated. Make a comparison. Results: the serum concentrations of TG,TC,LDL, in the three groups were compared, as shown in Table 2, and there was no significant difference between the three groups (p0.05). The serum creatinine of early CKD patients was significantly higher than that of 70-year-old healthy elderly (p0.01), but there was no significant difference in eGFR among the three groups (P 0.05). The levels of serum uric acid and serum cystine C and calcium in healthy elderly patients were lower than those in early CKD patients, and the levels of serum cystine C and serum calcium in healthy elderly patients were significantly higher than those in early CKD patients (p0.01, p0.01). There was no significant difference in serum sodium among the three groups (p0.05). Compared with the healthy elderly, the excretion rate of each substance in the early patients with CKD was significantly higher than that in the healthy elderly. Table 3 showed that FENa, FEC1 was significantly higher (P0.05, P 0.05). FEK, FECa,). There was no significant difference in FEUA (p0.05, p0.05). Conclusion: 1. The glomerular filtration rate of healthy elderly over 70 years old is the same as that of early CKD patients with diabetes mellitus and hypertension, but there is difference in substance excretion. The two are different pathophysiological states and need to be treated differently in clinic. 2. two銆，

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