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泰国成年人慢性肾脏病的患病率及危险因素:泰国 SEEK 研究。

Prevalence and risk factors of chronic kidney disease in the Thai adult population: Thai SEEK study.

机构信息

Section for Clinical Epidemiology and Biostatistics, Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Nephrol Dial Transplant. 2010 May;25(5):1567-75. doi: 10.1093/ndt/gfp669. Epub 2009 Dec 27.

Abstract

BACKGROUND

Previous reports of chronic kidney disease (CKD) prevalence in Thailand varied from 4.3% to 13.8%. However, there were methodological concerns with these reports in terms of generalization and the accuracy of estimation. This study was, therefore, conducted to determine CKD prevalence and its risk factors in Thai adult populations.

METHODS

The population-based Thai Screening and Early Evaluation of Kidney Disease (SEEK) study was conducted with cross-sectional stratified-cluster sampling. Serum creatinine was analysed using the modified Jaffe method and then standardized with isotope dilution mass spectrometry.

RESULTS

The study included 3,459 subjects were included in the study. The mean age was 45.2 years (SE = 0.8), and 54.5% were female. Six hundred and twenty-six subjects were identified as having CKD, which evidenced an overall CKD prevalence of 17.5% [95% confidence interval (95% CI) = 14.6-20.4%]. The CKD prevalence of Stages I, II, III and IV were 3.3% (95% CI = 2.5%, 4.1%), 5.6% (95% CI = 4.2%, 7.0%), 7.5% (95% CI = 6.2%, 8.8%) and 1.1% (95% CI = 0.7%, 1.5%), respectively. The prevalence of CKD was higher in Bangkok, the Northern and Northeastern regions than in the Central and Southern regions. Seven factors (i.e. age, gender, diabetes, hypertension, hyperuricaemia, history of kidney stones and the use of traditional medicines) were associated with CKD. Only 1.9% of the subjects were aware that they had CKD.

CONCLUSIONS

CKD prevalence in the Thai population is much higher than previously known and published. Early stages of CKD seem to be as common as later stages. However, albuminuria measurement was not confirmed and adjusting for persistent positive rates resulted in the prevalence of 14.4%. Furthermore, the awareness of CKD was quite low in the Thai population.

摘要

背景

以前泰国慢性肾脏病(CKD)的患病率报告范围为 4.3%至 13.8%。然而,这些报告在推广和估计准确性方面存在方法上的问题。因此,本研究旨在确定泰国成年人群中 CKD 的患病率及其危险因素。

方法

采用横断面分层聚类抽样方法进行基于人群的泰国筛查和早期肾脏病评估(SEEK)研究。使用改良的 Jaffe 法分析血清肌酐,然后用同位素稀释质谱法进行标准化。

结果

该研究共纳入 3459 名受试者。平均年龄为 45.2 岁(SE = 0.8),54.5%为女性。626 例被诊断为 CKD,总体 CKD 患病率为 17.5%[95%置信区间(95%CI)= 14.6%至 20.4%]。CKD 各期的患病率分别为 3.3%(95%CI= 2.5%至 4.1%)、5.6%(95%CI= 4.2%至 7.0%)、7.5%(95%CI= 6.2%至 8.8%)和 1.1%(95%CI= 0.7%至 1.5%)。曼谷、北部和东北部地区的 CKD 患病率高于中部和南部地区。7 个因素(年龄、性别、糖尿病、高血压、高尿酸血症、肾结石病史和传统药物使用)与 CKD 相关。只有 1.9%的患者知道自己患有 CKD。

结论

泰国人群的 CKD 患病率远高于以往已知和发表的水平。CKD 的早期阶段似乎与晚期阶段一样常见。然而,白蛋白尿的测量并未得到证实,调整持续阳性率后患病率为 14.4%。此外,CKD 在泰国人群中的知晓率相当低。

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