Almirall J, Vaqueiro M, Antón E, Baré M L, González V, Jaimez E, Gimeno C
Servicio de Nefrología, Institut Universitari Parc Taulí (UAB), Sabadell.
Nefrologia. 2005;25(6):655-62.
Chronic kidney disease is a major public health problem in developed countries. The incidence of patients on dialysis is increasing progressively in the last years. The ageing population and increasing incidence of diabetes and hypertension are the main causes. Moreover, the level of kidney function is now recognised as a major risk factor for cardiovascular disease, even in mild cases. There is a great unaware about the prevalence of mild to moderate chronic kidney disease in the general population. The aim of the present study was to know the kidney function level in our general population over 64 years old, and the associated cardiovascular risk.
This is an epidemiological descriptive cross-sectional study, obtained by a representative random sampling of the population over 64 years living in the reference area of our Hospital. The glomerular filtration rate was estimated by the Cockroft-Gault formula and the MDRD equations. Kidney function has been classified by the K/DOQI stages. We examined the univariate and multivariate association between the estimated glomerular filtration rate and the presence of cardiovascular events.
We analysed 253 subjects aged 65 to 93 years (mean 72 +/- 5.4). Present comorbidities were: HTA 64%, dislipemia 29%, diabetes 14%, active smokers: 10% of men, 1,5% of women. A previous cardiovascular event was present in 11% of patients (15% of men; 6,8% of women). A serum creatinin level over 1,3 and 1,5 mg/dl was present in 3,8% of women and 8% of men respectively. Nevertheless, chronic kidney insufficiency (estimated clreatinie clearance less than 60 mix') was present in 31-49% relying on the utilised formula. In addition to age, sex, and diabetes, an independent graded association was observed between reduced glomerular filtration rate and the existence of cardiovascular events.
We have confirmed a high prevalence of renal insufficiency among elderly people, usually not detected by the isolated plasma creatinin concentration This aspect is important for cardiovascular stratification risk and medical decisions (diagnostic and/or therapeutic). The level of glomerular filtration rate is independently associated with cardiovascular events.
慢性肾脏病是发达国家的一个主要公共卫生问题。近年来，透析患者的发病率在逐渐上升。人口老龄化以及糖尿病和高血压发病率的增加是主要原因。此外，即使在轻度病例中，肾功能水平现在也被认为是心血管疾病的一个主要危险因素。一般人群中轻度至中度慢性肾脏病的患病率很大程度上未被认识到。本研究的目的是了解我们医院64岁以上普通人群的肾功能水平以及相关的心血管风险。
这是一项流行病学描述性横断面研究，通过对居住在我院参考区域内64岁以上人群进行代表性随机抽样获得。采用Cockcroft - Gault公式和MDRD方程估算肾小球滤过率。肾功能根据K/DOQI分期进行分类。我们研究了估算的肾小球滤过率与心血管事件发生之间的单变量和多变量关联。
我们分析了253名年龄在65至93岁（平均72±5.4岁）的受试者。目前的合并症情况如下：高血压64%；血脂异常29%；糖尿病14%；现吸烟者：男性占10%，女性占1.5%。11%的患者曾有心血管事件（男性为15%；女性为6.8%）。血清肌酐水平超过1.3mg/dl和1.5mg/dl的女性分别占3.8%，男性占8%。然而，根据所使用的公式，31% - 49%的人存在慢性肾功能不全（估算肌酐清除率低于60ml/min）。除年龄、性别和糖尿病外，肾小球滤过率降低与心血管事件的存在之间存在独立的分级关联。
我们证实了老年人中肾功能不全的高患病率，通常单独的血浆肌酐浓度无法检测到这一点。这一方面对于心血管风险分层和医疗决策（诊断和/或治疗）很重要。肾小球滤过率水平与心血管事件独立相关。
