Katz I J, Gerntholtz T E, van Deventer M, Schneider H, Naicker S
Dumisani Mzamane African Institute of Kidney Disease, Soweto, University of the Witwatersrand, South Africa.
Clin Nephrol. 2010 Nov;74 Suppl 1:S113-8.
The aims of this paper are to examine whether early detection programs are needed to assist in detecting and managing chronic kidney disease (CKD). It draws on existing material which indicates that CKD and its precursor risk factors or illnesses such as hypertension, diabetes mellitus and HIV infection are very clearly major challenges faced by health systems worldwide. This paper evaluates whether CKD meets the epidemiological criteria to justify early screening. More compelling evidence is becoming available which indicates that the prevalence of CKD is significant in both developing and developed countries and that CKD can be easily detected and treated with only small changes to existing practice and this may be improved through screening programs. A brief evaluation of the challenges of establishing early detection programs is provided, as well as an examination of the capacity which exists for establishing such programs. It concludes that, despite the lack of randomized studies, these programs appear to provide an opportunity to integrate CKD management with common chronic illnesses and, through this approach, provide clinical and cost-effective management of both CKD and cardiovascular disease.
本文的目的是研究是否需要早期检测项目来协助检测和管理慢性肾脏病（CKD）。本文借鉴了现有资料，这些资料表明，CKD及其前驱危险因素或疾病，如高血压、糖尿病和HIV感染，显然是全球卫生系统面临的重大挑战。本文评估CKD是否符合进行早期筛查的流行病学标准。越来越多令人信服的证据表明，CKD在发展中国家和发达国家的患病率都很高，而且只需对现有做法稍作改变，CKD就可以很容易地被检测和治疗，通过筛查项目可能会有所改善。本文简要评估了建立早期检测项目所面临的挑战，并考察了建立此类项目的现有能力。结论是，尽管缺乏随机研究，但这些项目似乎提供了一个将CKD管理与常见慢性病整合的机会，并通过这种方法，对CKD和心血管疾病进行临床和具有成本效益的管理。
