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[慢性肾脏病:缺乏随机对照试验情况下的筛查态度与实践]

[Chronic kidney disease: screening attitude and practice in the absence of randomized controlled trials].

作者信息

Ponte Belén, Martin Pierre-Yves, Pechère Antoinette, Burnier Michel, Guessous Idris

机构信息

Département de médecine interne, HUG, 1211 Genève 14.

出版信息

Rev Med Suisse. 2010 Jul 14;6(256):1400-4.

Abstract

Given the increasing prevalence of chronic kidney disease (CKD), early detection has been proposed. Some organizations recommend CKD screening. Yet, the efficacy of CKD screening is unknown given the absence of randomized controlled trial conducted so far. While CKD screening tests (e.g., glomerular filtration rate) are simple and inexpensive, CKD screening can only be justified if it reduces CKD-related mortality and/or CKD-related morbidity compared to no screening. In addition, CKD screening must provide more benefits than risks to the participants and must be cost-effective. Based on observational studies and cost-effectiveness models, CKD screening has to be proposed to high risk population (patients with hypertension and/or diabetes) but not to the general population.

摘要

鉴于慢性肾脏病(CKD)的患病率不断上升,人们提出了早期检测的建议。一些组织建议进行CKD筛查。然而,由于迄今为止尚未进行随机对照试验,CKD筛查的效果尚不清楚。虽然CKD筛查测试(如肾小球滤过率)简单且成本低廉,但只有与不进行筛查相比,CKD筛查能够降低CKD相关死亡率和/或CKD相关发病率时,筛查才具有合理性。此外,CKD筛查必须为参与者带来比风险更多的益处,并且必须具有成本效益。基于观察性研究和成本效益模型,必须向高危人群(高血压和/或糖尿病患者)提议进行CKD筛查,而不是向普通人群提议。

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