Crook Errol D, Washington David O, Flack John M
Wayne State University School of Medicine, Harper University Hospital, Detroit, Michigan 48201, USA.
J Natl Med Assoc. 2002 Aug;94(8 Suppl):55S-62S.
The burden of kidney disease is disproportionately high in African Americans, and the condition often remains undiagnosed until late-stage disease. In order to reduce this burden, strategies must be implemented to improve the detection of kidney disease, and preventative measures must be targeted at those at greatest risk of disease. Important risk factors among African Americans in the US include hypertension, diabetes, and obesity. In this review, we discuss screening strategies that will allow earlier detection of kidney disease. The sensitivity of serum creatinine, proteinuria, and microalbuminuria as markers of disease are discussed, as is the importance of calculating glomerular filtration rates in individual patients. Implementation of community-based programs, such as the Kidney Early Evaluation Program developed by the National Kidney Foundation, can offer screening for kidney disease and its risk factors, and can educate and protect African Americans at risk of this prevalent disease.
肾病在非裔美国人中的负担格外沉重，而且这种疾病往往直到晚期才被诊断出来。为了减轻这一负担，必须实施相关策略以改善肾病的检测，并且预防措施必须针对那些患病风险最高的人群。在美国非裔美国人中，重要的风险因素包括高血压、糖尿病和肥胖。在这篇综述中，我们讨论了能够更早检测出肾病的筛查策略。文中讨论了血清肌酐、蛋白尿和微量白蛋白尿作为疾病标志物的敏感性，以及为个体患者计算肾小球滤过率的重要性。实施基于社区的项目，比如美国国家肾脏基金会制定的肾脏早期评估项目，可以提供肾病及其风险因素的筛查，并且能够教育和保护有患这种常见疾病风险的非裔美国人。
