Cirillo Massimo, Lombardi Cinzia, Chiricone Daniela, Bilancio Giancarlo, Marcarelli Fabiana, De Santo Natale G
Division of Nephrology, Second University of Naples, Via Sergio Pansini 5, Naples, Italy.
J Nephrol. 2008 Mar-Apr;21 Suppl 13:S102-6.
The paper deals with the use of estimated glomerular filtration rate (eGFR) as marker of low kidney function in the population. Data were collected on serum creatinine, other laboratory indices, blood pressure, and medical history in a population sample of 2083 men and 2491 women aged between 18-95 years. Estimated GFR was calculated by the equation of Modification Diet in Renal Disease study. Disorders included in the analysis were hypertension, cardiovascular disease, high serum uric acid, high serum phosphorus/low serum calcium, anemia, and high serum potassium. Prevalence of low eGFR (eGFR <60 mL/min per 1.73 m2) increased with age: from <1% for ages 18-24 to >30% for ages > or =75, P<0.001. On the basis of these data, prevalence of low eGFR in the adult Italian population was 5.7% for men (n=1.3 million, 95%CI = 1.1/1.5) and 6.2% for women (n=1.5 million, 95%CI = 1.3/1.8). Disorders associated with kidney dysfunction were two or more in the majority of persons with low eGFR and were more frequent with lower eGFR (p<0.001). Previous diagnosis of kidney disease was reported by less than 5% in people with low eGFR and was progressively higher with higher serum creatinine or with number of associated disorders (p<0.03). Hypertension tended to be more frequently treated but not more frequently controlled in people with low eGFR. Data support the use of eGFR to identify people with or at risk of low kidney function. Awareness of kidney disease is low in people with low eGFR unless serum creatinine is very high or they have many associated disorders.
本文探讨了估算肾小球滤过率（eGFR）作为人群中肾功能低下标志物的应用。研究收集了2083名年龄在18至95岁之间的男性和2491名女性的血清肌酐、其他实验室指标、血压和病史等数据。估算肾小球滤过率通过肾脏疾病饮食改良研究的公式计算得出。纳入分析的疾病包括高血压、心血管疾病、高血清尿酸、高血清磷/低血清钙、贫血和高血清钾。低eGFR（eGFR<60 mL/分钟/1.73 m²）的患病率随年龄增长而增加：18至24岁年龄段<1%，≥75岁年龄段>30%，P<0.001。基于这些数据，意大利成年人群中男性低eGFR的患病率为5.7%（n = 130万，95%CI = 1.1/1.5），女性为6.2%（n = 150万，95%CI = 1.3/1.8）。大多数低eGFR患者伴有两种或更多与肾功能障碍相关的疾病，且eGFR越低，这些疾病越常见（p<0.001）。低eGFR患者中既往肾病诊断报告率低于5%，且随着血清肌酐升高或相关疾病数量增加而逐渐升高（p<0.03）。低eGFR患者中高血压的治疗频率往往较高，但控制频率并不更高。数据支持使用eGFR来识别肾功能低下或有肾功能低下风险的人群。低eGFR患者对肾病的知晓率较低，除非血清肌酐非常高或他们有许多相关疾病。
