Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, MI 48103-4262, USA.
Adv Chronic Kidney Dis. 2010 May;17(3):271-81. doi: 10.1053/j.ackd.2010.03.001.
In recent years, there has been a general recognition of the importance of tackling noncommunicable chronic diseases throughout the world and not just in developed nations. Chronic kidney disease (CKD) is increasingly recognized as a public health threat, based on its high prevalence, rising incidence, associated complications, and cost. It is imperative that nations develop screening and surveillance programs related to CKD. This article provides a global perspective on existing and emerging CKD surveillance efforts. A variety of programs are described, ranging from cross-sectional screening studies to determine CKD prevalence; targeted screening of high-risk populations presenting for voluntary testing; to more systematic surveillance within the scope of integrated health care systems in many developed nations. The choice of surveillance programs for many countries will depend on available resources and competing health care priorities. Integration with surveillance programs for other major chronic diseases such as diabetes, hypertension, and obesity is highly desirable and could be a key to the prevention of CKD. Finally, we propose the model of integrated health systems as one that is perhaps best suited to systematic, longitudinal surveillance of many chronic diseases, a model based on a national electronic health care record with linkage across primary care and hospital-based programs. Robust health education efforts and timely dissemination strategies will remain the key to the success of disease surveillance. It is gratifying to note that more and more countries are developing and adopting CKD surveillance programs as part of national disease prevention strategies.
近年来，人们普遍认识到在全球范围内应对非传染性慢性疾病的重要性，而不仅仅是在发达国家。慢性肾脏病（CKD）因其高患病率、发病率上升、相关并发症和费用而日益被视为公共卫生威胁。各国制定与 CKD 相关的筛查和监测计划势在必行。本文提供了对现有和新兴的 CKD 监测工作的全球视角。本文描述了各种方案，从横断面筛查研究以确定 CKD 的患病率；对有自愿检测需求的高危人群进行有针对性的筛查；到许多发达国家在综合医疗保健系统范围内更系统地监测。许多国家对监测方案的选择将取决于可用资源和竞争的医疗保健优先事项。与其他主要慢性疾病（如糖尿病、高血压和肥胖症）的监测计划相结合是非常可取的，这可能是预防 CKD 的关键。最后，我们提出了综合卫生系统的模式，这可能是对许多慢性疾病进行系统、纵向监测的最佳模式，该模式基于具有初级保健和医院计划之间链接的国家电子医疗记录。强大的健康教育工作和及时的传播策略仍然是疾病监测成功的关键。值得欣慰的是，越来越多的国家正在制定和采用 CKD 监测计划，作为国家疾病预防战略的一部分。
