San Francisco General Hospital and University of California, San Francisco, 1001 Potrero Avenue, Building 10, Floor 3, San Francisco, CA 94110, USA.
Clin J Am Soc Nephrol. 2010 Apr;5(4):673-82. doi: 10.2215/CJN.07891109. Epub 2010 Mar 25.
Prevalence of chronic kidney disease (CKD) in people with diagnosed diabetes is known to be high, but little is known about the prevalence of CKD in those with undiagnosed diabetes or prediabetes. We aimed to estimate and compare the community prevalence of CKD among people with diagnosed diabetes, undiagnosed diabetes, prediabetes, or no diabetes.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The 1999 through 2006 National Health and Nutrition Examination Survey is a representative survey of the civilian, noninstitutionalized US population. Participants who were aged > or =20 years; responded to the diabetes questionnaire; and had fasting plasma glucose (FPG), serum creatinine, and urinary albumin-creatinine ratio measurements were included (N = 8188). Diabetes status was defined as follows: Diagnosed diabetes, self-reported provider diagnosis (n = 826); undiagnosed diabetes, FPG > or =126 mg/dl without self-reported diagnosis (n = 299); prediabetes, FPG > or =100 and <126 mg/dl (n = 2272); and no diabetes, FPG <100 mg/dl (n = 4791). Prevalence of CKD was defined by estimated GFR 15 to 59 ml/min per 1.73 m(2) or albumin-creatinine ratio > or =30 mg/g; adjustment was performed with multivariable logistic regression.
Fully 39.6% of people with diagnosed and 41.7% with undiagnosed diabetes had CKD; 17.7% with prediabetes and 10.6% without diabetes had CKD. Age-, gender-, and race/ethnicity-adjusted prevalence of CKD was 32.9, 24.2, 17.1, and 11.8%, for diagnosed, undiagnosed, pre-, and no diabetes, respectively. Among those with CKD, 39.1% had undiagnosed or prediabetes.
CKD prevalence is high among people with undiagnosed diabetes and prediabetes. These individuals might benefit from interventions aimed at preventing development and/or progression of both CKD and diabetes.
已知诊断为糖尿病的患者中慢性肾脏病（CKD）的患病率较高，但对于未诊断为糖尿病或糖尿病前期的患者中 CKD 的患病率知之甚少。我们旨在评估和比较诊断为糖尿病、未诊断为糖尿病、糖尿病前期或无糖尿病的人群中 CKD 的社区患病率。
设计、设置、参与者和测量：1999 年至 2006 年全国健康和营养检查调查是对美国非机构化平民人口的代表性调查。参与者年龄≥20 岁；回答了糖尿病问卷；并进行了空腹血糖（FPG）、血清肌酐和尿白蛋白/肌酐比值的测量（N=8188）。糖尿病的状态定义如下：诊断为糖尿病，自我报告的提供者诊断（n=826）；未诊断为糖尿病，FPG≥126mg/dl 且无自我报告的诊断（n=299）；糖尿病前期，FPG≥100 且<126mg/dl（n=2272）；无糖尿病，FPG<100mg/dl（n=4791）。CKD 的患病率通过估计肾小球滤过率 15 至 59ml/min/1.73m²或白蛋白/肌酐比值>或=30mg/g 定义；采用多变量逻辑回归进行调整。
诊断为糖尿病的患者中有 39.6%，未诊断为糖尿病的患者中有 41.7%患有 CKD；糖尿病前期患者中有 17.7%，无糖尿病患者中有 10.6%患有 CKD。经年龄、性别和种族/民族调整后，CKD 的患病率分别为诊断为糖尿病、未诊断为糖尿病、糖尿病前期和无糖尿病的患者中的 32.9%、24.2%、17.1%和 11.8%。在患有 CKD 的患者中，有 39.1%的患者患有未诊断或糖尿病前期。
未诊断为糖尿病和糖尿病前期的患者 CKD 的患病率较高。这些患者可能受益于旨在预防 CKD 和糖尿病发展和/或进展的干预措施。
