Kalaitzidis Rigas, Li Suying, Wang Changchun, Chen Shu-Cheng, McCullough Peter A, Bakris George L
Department of Medicine, Hypertensive Diseases Unit, Section of Endocrinology, Diabetes and Metabolism, University of Chicago, Pritzker School of Medicine, Chicago, IL 60637, USA.
Am J Kidney Dis. 2009 Apr;53(4 Suppl 4):S22-31. doi: 10.1053/j.ajkd.2008.11.028.
Chronic kidney disease (CKD) is a worldwide public health problem. Systolic blood pressure as an associated feature of CKD has not been fully explored in community volunteer and nationally representative samples of the US population.
This cross-sectional analysis evaluated hypertension and early-stage CKD in participants in the Kidney Early Evaluation Program (KEEP), a voluntary community-based health screening program administered by the National Kidney Foundation, and the National Health and Nutrition Examination Survey (NHANES) data to assess similarities and differences between these populations. Participants in both databases were 18 years or older.
The KEEP database included 88,559 participants and the NHANES included 20,095. Hypertension prevalence was greater in KEEP (69.6%) than NHANES (38.1%; P < 0.001). Compared with NHANES participants, KEEP participants had greater rates of obesity (79.5% versus 51.5%; P < 0.001) and diabetes (28.0% versus 8.9%; P < 0.001). In participants with diabetes, KEEP had slightly greater rates of prevalent hypertension (88.5% versus 85.7%; P = 0.03). In participants with hypertension, CKD stages 3 and 4 were more prevalent in KEEP than NHANES (79.1% versus 69.3%; P < 0.001). Rates of CKD stages 3 and 4 were greater in KEEP than NHANES for the following subgroups: African Americans (72.4% versus 57.4%; P < 0.001), smokers (69.1% versus 55.6%; P = 0.002), and participants with hypercholesterolemia (80.2% versus 71.9%; P < 0.001).
In the volunteer KEEP population, rates of hypertension and CKD were greater than in NHANES, most prominently in African Americans and participants with increased cardiovascular risk.
慢性肾脏病（CKD）是一个全球性的公共卫生问题。收缩压作为CKD的一个相关特征，在美国社区志愿者和具有全国代表性的人群样本中尚未得到充分研究。
这项横断面分析评估了肾脏早期评估项目（KEEP，由美国国家肾脏基金会管理的一个基于社区的自愿健康筛查项目）参与者以及美国国家健康与营养检查调查（NHANES）数据中的高血压和早期CKD情况，以评估这两个人群之间的异同。两个数据库中的参与者均为18岁及以上。
KEEP数据库包含88,559名参与者，NHANES包含20,095名。KEEP中的高血压患病率（69.6%）高于NHANES（38.1%；P<0.001）。与NHANES参与者相比，KEEP参与者的肥胖率（79.5%对51.5%；P<0.001）和糖尿病率（28.0%对8.9%；P<0.001）更高。在糖尿病患者中，KEEP的高血压患病率略高（88.5%对85.7%；P = 0.03）。在高血压患者中，KEEP中3期和4期CKD比NHANES更常见（79.1%对69.3%；P<0.001）。在以下亚组中，KEEP中3期和4期CKD的发生率高于NHANES：非裔美国人（72.4%对57.4%；P<0.001）、吸烟者（69.1%对55.6%；P = 0.002）以及高胆固醇血症患者（80.2%对71.9%；P<0.001）。
在自愿参与的KEEP人群中，高血压和CKD的发生率高于NHANES，在非裔美国人和心血管风险增加的参与者中最为显著。
