Investigation on the Incidence and Influencing Factors of Proteinuria and Renal Dysfunction in Community-dwelling Elderly Population

Abstract

Background The elderly tend to coexist with multiple chronic diseases (such as diabetes and hypertension) , while diabetes and hypertension can lead to chronic kidney damage, and fewer studies have been conducted on chronic kidney disease in older adults. Objective To investigate the proteinuria and renal dysfunction in the elderly population and provide guidance for the management of chronic kidney disease in the community-dwelling older adults by collecting the clinical data of physical examination of the elderly residents in community. Methods A total of 13 080 elderly residents who underwent physical examination in Zhuanqiao Community Health Service Center of Minhang District, Shanghai from 2020 to 2021 were included as the study objects. General information, physical examination results and laboratory examination data of study objects were collected. Subjects with estimated glomerular filtration rate (eGFR) <60 mL·min-1· (1.73 m2) -1 were included in the abnormal renal function group (n=713) , and subjects with eGFR≥60 mL·min-1· (1.73 m2) -1 were included in the normal renal function group (n=12 367) . The subjects with positive urine protein were included in the proteinuria group (n=1 690) , and the subjects with negative urine protein were included in the non-proteinuria group (n=11 390) . At the same time, the subjects were divided into 60 to 69 years old group (n=6 901) , 70 to 79 years old group (n=4 867) , 80 to 89 years old group (n=1 128) and ≥90 years old group (n=184) according to the age interval of 10 years. Multivariate Logistic regression analysis was used to explore the influencing factors of renal dysfunction and proteinuria in the study population. Results There were significant differences in the detection rates of urine protein positive and renal dysfunction in 60 to 69 years old, 70 to 79 years old, 80 to 89 years old and ≥90 years old groups (P<0.05) . The detection rate of urinary protein positive in males aged 60 to 69 years and 70 to 79 years was higher than that in females, the detection rate of renal dysfunction in males aged 60 to 69 years was higher than females, and the detection rate of renal dysfunction in males aged 80 to 89 years was lower than females, the difference was statistically significant (P<0.05) . Age, the proportion of diabetes and hypertension, blood urea nitrogen (BUN) , serum creatinine (Scr) and triglyceride (TG) in the abnormal renal function group were higher than those in the normal renal function group, while total cholesterol (TC) , high-density lipoprotein cholesterol (HDL-C) , low density lipoprotein cholesterol (LDL-C) and hemoglobin (Hb) in the abnormal renal function group were lower than those in the normal renal function group. There was significant difference in urinary, albumin/creatinine ratio (ACR) between the two groups (P<0.05) . Multivariate Logistic regression analysis showed that age, hypertension, diabetes, proteinuria and anemia were the influencing factors of renal dysfunction (P<0.05) , while male, diabetes, obesity, hypertriglyceridemia, Scr and BNU were the influencing factors of proteinuria (P<0.05) . Conclusion The detection rates of proteinuria and renal dysfunction in the elderly aged 60 years and above are high, which increase with age. Age, hypertension, diabetes, anemia, hypertriglyceridemia and low HDL-C level are risk factors for renal dysfunction in community-dwelling elderly population (P<0.05) ; male, diabetes, obesity, hypertriglyceridemia, Scr and BUN are risk factors for proteinuria in community-dwelling elderly population.

Keywords

• renal insufficiency|albuminuria|aged|community health services|root cause analysis