| Summary: | 碩士 === 美和科技大學 === 健康照護研究所 === 100 === The high incidence and prevalence rate of end stage renal disease (ESRD) in Taiwan are problems that warrant concern and attention. Furthermore, chronic kidney disease (CKD) is a condition that occurs earlier than ESRD and has a greater prevalence rate. Because CKD increases the rate of cardiovascular disease mortality, resulting in increased healthcare expenditures and burdens and causing significant mental and financial hardships for individuals, families, and society, efforts have been made worldwide to prevent this disease. The purpose of this study is to examine the relationship between uric acid concentration levels and CKD in people aged 40 y and above in southern Taiwan to serve as a reference for CKD prevention.
This is a cross-sectional study of 9,450 people recruited as the study population who received free adult health examinations provided by a hospital in a certain district in Kaohsiung City between July, 2005 and July, 2011. The participants’ basic information questionnaires and physical examination and blood examination results were obtained. CKD diagnosis standards followed those set by the U.S. National Kidney Foundation kidney disease outcomes quality initiative (K/DOQI) in 2002. The relationship between hyperuricemia and CKD is examined and multiple logistic regression analysis is employed to identify factors affecting CKD. The study results show a 45.1% prevalence rate of hyperuricemia in CKD patients, and the proportion of CKD patients with hypertension,obesity, hyperglycemia, hypertriglyceridemia, metabolic syndrome, anemia, and abnormal proteinuria are 34.3%, 33.6%, 61.3%, 34.3%, 34.6%, 45.4%, and 78.1%, respectively, which were all significantly different (p < .001) statistically and higher from those of healthy people. CKD patients with hyperuricemia combined with risk factors (hypertension, hyperglycemia, hypercholesterolemia, hypertriglyceridemia, obesity, proteinuria and metabolic syndrome) showed a significantly higher abnormal rate than those without combined risk factors, achieving a statistically significant difference (p < .001). The multiple logistic regression analysis results show people aged 65 y and above were 3.53 times more likely to develop CKD than people aged between 40-64 y (95% CI = 3.20-3.90). Regarding gender, men were more likely to have CKD than women (OR-1.13, 95% CI = 1.02-1.25). People with an abnormal uric acid level had a 2.9 times increased risk of developing CKD (95% CI = 2.62-3.21), and people with anemia were 2.17 times more likely to have CKD (95% CI = 1.92-2.46). Having metabolic syndrome led to patients 1.37 more likely of developing CKD (95% CI = 1.24-1.52). Daily intake of vegetables and fruits was identified as a protective factor against CKD and contributed to a 15% decrease in the risk for CKD (95% CI = 0.76-0.94).
The study observed the CKD prevalence rate increases with age.Furthermore, gender, daily intake of 3 plates of vegetables and 2 portions of fruits, uric acid, anemia, and metabolic syndrome could be adopted as critical predictive factors for CKD risk. Therefore, the study results could serve as a reference for the CKD prevention policy to decrease the incidence of ESRD and cardiovascular diseases.
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