Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Nephrol Dial Transplant. 2011 May;26(5):1592-9. doi: 10.1093/ndt/gfq608. Epub 2010 Oct 12.
The prevalence of chronic kidney disease (CKD) at high altitude is not known. We conducted a population-based survey in Tibet to identify the prevalence and associated risk factors of CKD in subjects living at altitudes of > 3500 m.
One thousand two hundred and eighty-nine Tibetans (≥ 18 years) from four districts of Lhasa city (altitude 3658 m) and eight villages of Dangxiong County (altitude 4200 m) were interviewed and tested for haematuria, albuminuria and estimated glomerular filtration rate (eGFR).
The adjusted prevalence of hypertension, albuminuria, haematuria and reduced eGFR were 38.8% (95% CI: 36.2-41.5%), 16.2% (95% CI: 14.1-18.2%), 3.9% (95% CI: 2.8-4.9%) and 2.1% (95% CI: 1.3-2.9%), respectively. Both the presence of hypertension and the presence of albuminuria were strongly and independently associated with hyperuricaemia and elevated haematocrit.
This is the first population-based epidemiological study of CKD in the Tibetan population. We found a higher prevalence of CKD and associated high prevalence of albuminuria, hypertension, hyperuricaemia and high haematocrit in the Tibetan population. The present study indicates the urgent need to develop comprehensive strategies targeted at reducing the CKD burden in this area and may lead to a better understanding of CKD in high-altitude populations.
目前尚不清楚高海拔地区慢性肾脏病（CKD）的流行情况。我们在西藏进行了一项基于人群的调查，以确定生活在海拔>3500 米的人群中 CKD 的患病率及其相关危险因素。
从拉萨市四个区（海拔 3658 米）和当雄县八个村庄（海拔 4200 米）中招募了 1289 名藏族（≥18 岁）居民进行访谈和血尿、蛋白尿和估算肾小球滤过率（eGFR）检测。
调整后的高血压、蛋白尿、血尿和 eGFR 降低的患病率分别为 38.8%（95%CI：36.2-41.5%）、16.2%（95%CI：14.1-18.2%）、3.9%（95%CI：2.8-4.9%）和 2.1%（95%CI：1.3-2.9%）。高血压和蛋白尿的存在与高尿酸血症和红细胞压积升高均呈强烈且独立相关。
这是藏族人群中首次基于人群的 CKD 流行病学研究。我们发现藏族人群中 CKD 的患病率较高，且蛋白尿、高血压、高尿酸血症和高红细胞压积的患病率也较高。本研究表明，迫切需要制定针对该地区 CKD 负担的综合策略，这可能有助于更好地了解高原人群中的 CKD。
