摘要目的:分析24 h尿钙排泄量与慢性肾脏病（CKD）严重程度及预后的相关性。方法:选择中国慢性肾脏病队列研究中3 375例的CKD 1~4期（18~74岁）的参与者为研究对象，采用Kaplan-Meier生存模型和Cox比例风险回归模型等进行时间-事件分析，以探索24 h尿钙排泄量与终末期肾脏病（ESKD）、心血管疾病（CVD）和全因死亡事件发生率之间的关联性。结果:在4.17（3.37，5.20）年的随访时间内，24 h尿钙排泄量<0.60、0.60~、1.20~、≥2.32 mmol组中分别有179、145、104和38例发展为ESKD。与24 h尿钙排泄量<0.60 mmol相比，高水平尿钙排泄量（1.20~、≥2.32 mmol）与CKD患者较低的ESKD事件发生风险相关， HR值（95% CI）分别为0.71（0.54~0.93）和0.43（0.29~0.64）。24 h尿钙排泄量与CVD和全因死亡事件终点无统计学关联。 结论:在CKD患者中，24 h尿钙排泄量与CKD患者ESKD事件的发生风险相关。

abstractsObjective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.