Scavini Marina, Stidley Christine A, Paine Susan S, Shah Vallabh O, Tentori Francesca, Bobelu Arlene, Welty Thomas K, MacCluer Jean W, Zager Philip G
Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87102, USA.
Clin J Am Soc Nephrol. 2007 May;2(3):509-16. doi: 10.2215/CJN.02780806. Epub 2007 Apr 18.
The Zuni Indians of New Mexico are experiencing an epidemic of chronic kidney disease (CKD). The Zuni Pueblo created the Zuni Kidney Project (ZKP) to decrease the burden of CKD in the community. The aim of this study was to estimate the prevalence of CKD among Zuni Indians using National Kidney Foundation Kidney Disease Outcomes Quality Initiative criteria. The ZKP conducted a population-based, cross-sectional survey to estimate the prevalence of CKD and related risk factors among Zuni Indians aged > or =20 yr (n = 1113). GFR was estimated using equations based on serum creatinine, and urine albumin:creatinine ratio was calculated in a single spot urine sample. ESRD counts were obtained from health care providers. The age- and sex-adjusted prevalence of CKD among the Zuni Indians was >2.5-fold higher than that among the US composite population. The estimated prevalence of CKD stages 1 and 2 combined was three- to four-fold higher than that of CKD stages 3 and 4 combined. This ratio was significantly higher than that in the US composite population (1.4-fold). The prevalence of CKD stage 5 was eight-fold higher among the Zuni Indians than among the composite US population. The Zuni Indians have an expanded pool of CKD that contributes to the high burden of ESRD. The high prevalence of CKD stages 1 and 2 provides a unique opportunity to develop innovative treatment programs to reduce the burden of CKD in Zuni Pueblo.
新墨西哥州的祖尼印第安人正经历慢性肾病（CKD）的流行。祖尼部落创建了祖尼肾脏项目（ZKP），以减轻该社区慢性肾病的负担。本研究的目的是使用美国国家肾脏基金会肾脏病预后质量倡议标准，估算祖尼印第安人中慢性肾病的患病率。ZKP开展了一项基于人群的横断面调查，以估算年龄≥20岁的祖尼印第安人（n = 1113）中慢性肾病及相关危险因素的患病率。采用基于血清肌酐的公式估算肾小球滤过率（GFR），并在单次随机尿样中计算尿白蛋白与肌酐比值。从医疗服务提供者处获取终末期肾病（ESRD）病例数。祖尼印第安人中慢性肾病经年龄和性别调整后的患病率比美国总体人群高2.5倍以上。估算的1期和2期慢性肾病合并患病率比3期和4期慢性肾病合并患病率高3至4倍。该比值显著高于美国总体人群（1.4倍）。祖尼印第安人中5期慢性肾病的患病率比美国总体人群高8倍。祖尼印第安人慢性肾病患者群体扩大，这导致了终末期肾病的高负担。1期和2期慢性肾病的高患病率为制定创新治疗方案以减轻祖尼部落慢性肾病负担提供了独特契机。
