Ryan Timothy P, Sloand James A, Winters Paul C, Corsetti James P, Fisher Susan G
Department of Community and Preventive Medicine, Division of Epidemiology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
Am J Med. 2007 Nov;120(11):981-6. doi: 10.1016/j.amjmed.2007.05.012.
Chronic kidney disease is a major public health problem. However, no study to date has estimated the prevalence of chronic kidney disease based on the clinical guidelines established by the National Kidney Foundation and few studies have explored the rate of diagnoses by primary care providers.
Cross-sectional study of ambulatory patients in Rochester, NY. The purpose of this study was to estimate the prevalence of chronic kidney disease and the rate of primary caregiver diagnosis in ambulatory patients with chronic kidney disease.
Among the 24,492 outpatients that had at least 2 glomerular filtration rate estimates > or =3 months apart, 6895 had an estimated glomerular filtration rate <60 mL/min/1.73 m2, indicating a 28.2% period prevalence of chronic kidney disease. The rate of clinical diagnosis among those with chronic kidney disease was 26.5% (95% confidence interval, 17.9 to 35.1), suggesting that 74% of patients with chronic kidney disease are undiagnosed.
We demonstrate that the prevalence of chronic kidney disease is substantially higher in health-seeking individuals than in the general population. Moreover, we demonstrate that laboratory reporting of estimated glomerular filtration rate using the Modification of Diet in Renal Disease equation alone does not result in an optimal rate of clinical diagnosis.
慢性肾脏病是一个主要的公共卫生问题。然而，迄今为止尚无研究依据美国国立肾脏基金会制定的临床指南来估算慢性肾脏病的患病率，且仅有少数研究探讨了初级保健提供者的诊断率。
对纽约州罗切斯特市的门诊患者进行横断面研究。本研究的目的是估算慢性肾脏病在门诊患者中的患病率以及初级保健提供者对慢性肾脏病的诊断率。
在至少有两次间隔≥3个月的肾小球滤过率估算值的24492名门诊患者中，6895人的估算肾小球滤过率<60 mL/（min·1.73 m²），表明慢性肾脏病的期间患病率为28.2%。慢性肾脏病患者的临床诊断率为26.5%（95%置信区间为17.9%至35.1%），这表明74%的慢性肾脏病患者未被诊断。
我们证明，寻求医疗服务的个体中慢性肾脏病的患病率显著高于一般人群。此外，我们证明仅使用肾脏病饮食改良公式进行估算肾小球滤过率的实验室报告并不能带来最佳的临床诊断率。
