بررسی اپیدمیولوژیک عوامل جمعیت‌شناختی و پایه‌ای بالینی مبتلایان به بیماری مزمن کلیوی شهر اصفهان در بازه‌ی زمانی 90-1375

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استاد، مرکز تحقیقات بیماری‌های کلیه و گروه نفرولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، کمیته‌ی تحقیقات دانشجویی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دانشیار، گروه آمار و اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: بیماری مزمن کلیوی (Chronic kidney disease یا CKD) یک بیماری پیش‌رونده است. به دنبال افزایش بیش از پیش چاقی و دیابت، شیوع CKD در حال افزایش است. شیوع CKD در ایران، 7/23-5/6 برآورد شده است. پیشرفت CKD به طور عمده به خاطر عوامل ثانویه‌ای می‌باشد که اغلب ارتباطی به فعالیت بیماری اولیه ندارند. عوامل ثانویه، شامل عوامل جمعیت‌شناختی، عوامل بالینی و الگوی مصرف داروهای کاهنده‌ی فشار خون می‌باشد. این مطالعه، با هدف بررسی اپیدمیولوژیک عوامل جمعیت‌شناختی و پایه‌ای بالینی مبتلایان به بیماری مزمن کلیوی در شهر اصفهان در سال‌های 90-1375 انجام شد.روش‌ها: مطالعه‌ی حاضر، یک مطالعه‌ی مقطعی بود که بر روی 504 بیمار مبتلا به بیماری مزمن کلیوی در پاییز سال 1394 انجام شد. با استفاده از پرسش‌نامه، اطلاعات مربوط به وزن، قد و شاخص توده‌ی بدنی، داروهای کاهنده‌ی فشار خون، فشار خون پایه و سالیانه‌ی بیمار، بیماری زمینه‌ای، پروتئینوری، میزان کراتینین و فیلتراسیون گلومرولی تخمین زده شده از پرونده‌ی بیماران استخراج شد.یافته‌ها: از 504 شرکت کننده، 6/48 درصد مرد و 4/51 درصد زن بودند. میانگین سنی جمعیت 06/17 ± 64/46 سال بود. میانگین فیلتراسیون گلومرولی برآورد شده‌ی اولیه در بیماران 05/32 ± 33/73 میلی‌لیتر/دقیقه/73/1 مترمربع بود. 4/55 درصد بیماران پروتئینوری داشتند. 1/32 درصد افراد مبتلا به دیابت بودند. گروه دارویی Angiotensin converting enzyme inhibitors (ACE inhibitor) و Vasodilator به ترتیب با توزیع فراوانی 9/76 و 6/0 درصد، پرمصرف‌ترین و کم‌مصرف‌ترین داروها بودند.نتیجه‌گیری: ویژگی‌های جمعیت‌شناختی و پایه‌ای بالینی در این مطالعه به طور تقریبی مشابه سایر مطالعات انجام شده در کشور بود؛ با این تفاوت اساسی که درصد قابل توجهی از بیماران را افراد جوان‌تر تشکیل می‌دادند. شیوع دیابت و گلومرولونفریت از اغلب آمارهای ذکر شده در ایران بیشتر بود. الگوی مصرف داروهای کاهنده‌ی فشار خون نیز با الگوی ذکر شده در راهنماها مطابقت بیشتری داشت. سرعت کاهش Estimated glomerular filtration rate (eGFR) سالانه به طور قابل توجهی کند می‌باشد که قابل توجه است.

کلیدواژه‌ها

عنوان مقاله [English]

Epidemiologic Evaluation of Demographic and Basic Clinical Factors in Patients with Chronic Kidney Disease in Isfahan City, Iran, during 1996-2011

نویسندگان [English]

  • Shahrzad Shahidi 1
  • Esmail Hadizadeh 2
  • Pooria Shaabani 2
  • Awat Feizi 3
1 Professor, Isfahan Kidney Diseases Research Center AND Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Associate Professor, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Chronic kidney disease (CKD) is a progressive disease. The prevalence of CKD continues to increase significantly due to increasing prevalence of diabetes and obesity and has been estimated 6.5 to 23.7 percent in Iran. The CKD progression may be largely due to secondary factors that are sometimes unrelated to the activity of the initial disease. These include demographic and clinical characteristics and the pattern of antihypertensive drug consumption.Methods: This cross-sectional study was performed in autumn 2014 on 504 patients with chronic kidney disease in Isfahan City, Iran, during 1996-2011. Data on sex, weight, height, body mass index, antihypertensive drug, basic and mean annually blood pressure, underlying disease, proteinuria, serum creatinine, and Estimated Glomerular Filtration Rate (eGFR) were collected using a questionnaire.Findings: 504 subjects (48.6% men and 51.4% women) with a mean age of 46.64 ± 17.06 years were enrolled in this study. Basic eGFR was 73.33 ± 32.05 ml/min/1.73 m2. Proteinuria was seen in 55.4% of patients. The prevalence of diabetes was 32.1%. Angiotensin converting enzyme (ACE) inhibitor was the most common drug class used by participants and accounted for 76.9% of the utilization; vasodilators were the least used antihypertensive drugs and represented as 0.6% of the total utilization.Conclusion: The demographic and basic clinical characteristics of our study population nearly were similar to other studies in Iranian population, with these major differences that our participants were significantly younger, and the prevalence of diabetes and glomerulonephritis were higher in comparison to other studies. The utilization pattern of antihypertensive drugs had more accordance with clinical guidelines. The rate of eGFR reduction was significantly slow.

کلیدواژه‌ها [English]

  • Chronic kidney disease
  • Demographic factors
  • Basic clinical factors

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مجله دانشکده پزشکی اصفهان
دوره 35، شماره 448 - شماره پیاپی 448
مهر و آبان 1396
صفحه 1298-1308

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سابقه مقاله

  • تاریخ دریافت: 17 مهر 1396
  • تاریخ بازنگری: 12 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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