Nephrology and Renal Transplantation Unit and Consiglio Nazionale delle Ricerche, Instituto di Biomedicina, Ospedali Riuniti, Reggio Cal, Italy.
Clin J Am Soc Nephrol. 2009 Dec;4 Suppl 1:S18-22. doi: 10.2215/CJN.05210709.
Chronic kidney disease is now considered a public health priority, and the prevalence of this disease is approximately 10% in both North American and European countries. Such a phenomenon raises concern about the future increased incidence of ESRD. A recent analysis in the European Renal Association-European Dialysis and Transplant Association Registry shows that the incidence rates in Northern European countries have stabilized at approximately 110 per million people, a phenomenon that is associated with a parallel stabilization in the incidence of ESRD caused by diabetes. Such a stabilization has occurred in the face of an increasing prevalence of diabetes and hypertension in the general population, suggesting that this improvement may be the result of better prevention. Genetic factors, competing risks with other diseases, and other medical factors explain only in part the variability in the incidence of renal replacement therapy in European countries. Health care financing priorities have an obvious influence on the outcome of ESRD. Nonmedical factors seem to be of importance at least equal to that of medical factors. In this respect, Dialysis Outcomes and Practice Patterns Study Europe has revealed relevant differences in clinical policies that are related to ESRD treatment among European countries.
慢性肾脏病现已被视为公共卫生重点，北美和欧洲国家的发病率约为 10%。这种现象引发了对未来终末期肾病发病率上升的担忧。欧洲肾脏协会-欧洲透析和移植协会登记处最近的一项分析显示，北欧国家的发病率已稳定在每百万人 110 左右，这一现象与糖尿病引起的终末期肾病发病率的平行稳定有关。在普通人群中糖尿病和高血压患病率不断上升的情况下，出现了这种稳定现象，这表明这种改善可能是更好的预防措施的结果。遗传因素、与其他疾病的竞争风险以及其他医疗因素仅部分解释了欧洲国家接受肾脏替代治疗的发病率差异。医疗保健融资重点对终末期肾病的结果有明显影响。非医疗因素似乎至少与医疗因素同样重要。在这方面，欧洲透析结局和实践模式研究揭示了与欧洲国家终末期肾病治疗相关的临床政策方面的相关差异。
