基于多因素Cox回归模型的糖尿病肾病进展的危险因素分析OA

Objective To investigate the risk factors of renal failure in diabetic kidney disease patients by us-ing the multivariate Cox model.Methods Clinical data of diabetic kidney disease patients were collected from the Second Hospital of Lanzhou University from January 2013 to October 2024.The risk factors of renal failure in diabetic kidney disease patients were analyzed by the time-segmented method and multivariate Cox regression model.Results The rates of renal failure in the first year,the second to fourth year and the fourth to eleventh year were 0%,20%and 42.95%,respectively.Multivariate Cox analysis showed poor glycemic control(HR=13.15,95%CI:[3.03,57.02],P<0.001),hypertension(HR=12.01,95%CI:[2.83,51.01],P<0.001),advanced age(HR=3.22,95%CI:[1.35,7.66],P=0.008),longer duration of diabetes(HR=1.08,95%-0.050.019),and higher systolic blood pressure(HR=1.02,95%CI:[1.00,1.03],P=0.024)were risk factors for renal function progression.On the other hand,a higher hemoglobin concentration(HR=0.99,95%CI:[0.98,1.00],P=0.021),higher estimated glomerular filtration rate(HR=0.96,95%CI:[0.94,0.97],P<0.001),high-er albumin(HR=0.95,95%CI:[0.92,0.99],P=0.008),older age of diabetic diagnosis(HR=0.94,95%CI:[0.91,0.96],P<0.001),and early insulin therapy(HR=0.91,95%CI:[0.86,0.97],P=0.001)were protective factors against renal function progression.Conclusion Multivariate Cox regression analysis identified the risk and protective factors,highlighting that a comprehensive strategy of"early detection,comprehensive assess-ment,proactive intervention,and multi-target management"should be implemented in clinical practice to delay the progression of diabetic kidney disease.