中国肾脏病流行病学调查(2012柳叶刀)

中国第一个大型肾脏病流行病学调查

Articles

Prevalence of chronic kidney disease in China: a cross-sectional survey

Luxia Zhang*, Fang Wang*, Li Wang , Wenke Wang , Bicheng Liu , Jian Liu , Menghua Chen , Qiang He , Yunhua Liao , Xueqing Yu , Nan Chen , Jian-e Zhang, Zhao Hu, Fuyou Liu, Daqing Hong, Lijie Ma, Hong Liu, Xiaoling Zhou, Jianghua Chen, Ling Pan, Wei Chen, Weiming Wang, Xiaomei Li, Haiyan Wang

Summary

Background The prevalence of chronic kidney disease is high in developing countries. However, no national survey of chronic kidney disease has been done incorporating both estimated glomerular ltration rate (eGFR) and albuminuria in a developing country with the economic persity of China. We aimed to measure the prevalence of chronic kidney disease in China with such a survey.

Methods We did a cross-sectional survey of a nationally representative sample of Chinese adults. Chronic kidney disease was de ned as eGFR less than 60 mL/min per 1·73 m² or the presence of albuminuria. Participants completed a lifestyle and medical history questionnaire and had their blood pressure measured, and blood and urine samples taken. Serum creatinine was measured and used to estimate glomerular ltration rate. Urinary albumin and creatinine were tested to assess albuminuria. The crude and adjusted prevalence of indicators of kidney damage were calculated and factors associated with the presence of chronic kidney disease analysed by logistic regression.

Lancet 2012; 379: 815–822See Editorial page 777See Comment page 783*These authors contributed equally

These authors contributed equally

Peking University Institute of Nephrology, Division of

Nephrology, Peking University First Hospital, Beijing, China (L Zhang MD, F Wang MD,

Prof X Li MD, Prof H Wang MD);

Findings 50 550 people were invited to participate, of whom 47 204 agreed. The adjusted prevalence of eGFR less than Division of Nephrology,

Sichuan Academy of Medical

60 mL/min per 1·73 m² was 1·7% (95% CI 1·5–1·9) and of albuminuria was 9·4% (8·9–10·0). The overall prevalence Sciences and Sichuan

of chronic kidney disease was 10·8% (10·2–11·3); therefore the number of patients with chronic kidney disease in Provincial People’s Hospital, China is estimated to be about 119·5 million (112·9–125·0 million). In rural areas, economic development was Chengdu, China

;

independently associated with the presence of albuminuria. The prevalence of chronic kidney disease was high in north (Prof L Wang MD, D Hong MD)

Division of Nephrology,

(16·9% [15·1–18·7]) and southwest (18·3% [16·4–20·4]) regions compared with other regions. Other factors Chifeng Second Hospital, independently associated with kidney damage were age, sex, hypertension, diabetes, history of cardiovascular disease, Chifeng, China

(Prof Wen Wang MD, L Ma MD); hyperuricaemia, area of residence, and economic status.

Institute of Nephrology and Division of Nephrology,

Interpretation Chronic kidney disease has become an important public health problem in China. Special attention Zhongda Hospital, Southwest

University, Nanjing, China should be paid to residents in economically improving rural areas and speci c geographical regions in China.

(Prof B Liu MD, H Liu MD); Division of Nephrology, the

Funding The Ministry of Science and Technology (China); the Science and Technology Commission of Shanghai; the First Hospital of Xinjiang National Natural Science Foundation of China; the Department of Health, Jiangsu Province; the Sichuan Science and University of Medicine,

Technology Department; the Ministry of Education (China); the International Society of Nephrology Research Uramuqi, China (Prof J Lui MD);

Division of Nephrology, the Committee; and the China Health and Medical Development Foundation.

A liated Hospital of Ningxia University of Medicine,

will result in an even greater burden of chronic kidney Yinchuan, China

In the past 10 years, chronic kidney disease has received disease in the future, and is likely to have substantial (Prof M Chen MD, X Zhou MD);

quences in Division of Nephrology, the increased attention as a leading public health problem. socioeconomic and public health conse

First A liated Hospital of

The burden of chronic kidney disease is not restricted resource-poor countries.4 China is the world’s largest Zhejiang University, to its e ect on demands for renal replacement therapy; developing country. Previous studies have indi cated that Hangzhou, China the disease has other major e ects on the overall the prevalence of chronic kidney disease di ers sub-(Prof Q He MD, J Chen MD); population. For example, in the general population, stantially between geographical regions in China.6–9 This Division of Nephrology, the

First A liated Hospital,

and in high-risk diabetic or hypertensive populations, hetero geneity might be related to variability in lifestyles Guangxi University of outcomes, especially mortality and cardiovascular and economic development, or di erences in study Medicine, Nanning, China

1–3 6–9

events, are strongly a ected by kidney involvement.methodology. National surveys of chronic kidney (Prof Y Liao MD, L Pan MD); Therefore, through its e ect on cardiovascular risk disease prevalence in a developing country that incor-Division of Nephrology, the

First A liated Hospital, Sun

ltration rate (eGFR) and Yat-sen University, and outcomes as well as end-stage renal disease, porate estimated glomerular

chronic kidney disease directly a ects the global albuminuria, as well as the ethnic and economic Guangzhou, China

(Prof X Yu MD, W Chen MD); burden of death caused by cardiovascular …… 此处隐藏：50987字，全部文档内容请下载后查看。喜欢就下载吧 ……