Department of Clinical Pharmacology and General Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
Kidney Int. 2011 Dec;80(11):1212-21. doi: 10.1038/ki.2011.258. Epub 2011 Aug 10.
The global prevalence of chronic kidney disease (CKD) of uncertain etiology may be underreported. Community-level epidemiological studies are few due to the lack of national registries and poor focus on the reporting of non-communicable diseases. Here we describe the prevalence of proteinuric-CKD and disease characteristics of three rural populations in the North Central, Central, and Southern Provinces of Sri Lanka. Patients were selected using the random cluster sampling method and those older than 19 years of age were screened for persistent dipstick proteinuria. The prevalence of proteinuric-CKD in the Medawachchiya region (North Central) was 130 of 2600 patients, 68 of 709 patients in the Yatinuwara region (Central), and 66 of 2844 patients in the Hambantota region (Southern). The mean ages of these patients with CKD ranged from 44 to 52 years. Diabetes and long-standing hypertension were the main risk factors of CKD in the Yatinuwara and Hambantota regions. Age, exceeding 60 years, and farming were strongly associated with proteinuric-CKD in the Medawachchiya region; however, major risk factors were uncertain in 87% of these patients. Of these patients, 26 underwent renal biopsy; histology indicated tubulointerstitial disease. Thus, proteinuric-CKD of uncertain etiology is prevalent in the North Central Province of Sri Lanka. In contrast, known risk factors were associated with CKD in the Central and Southern Provinces.
全球病因不明的慢性肾脏病（CKD）的流行情况可能被低估了。由于缺乏全国性登记处和对非传染性疾病报告的重视不足，社区层面的流行病学研究很少。在这里，我们描述了斯里兰卡中北部、中部和南部三个农村地区蛋白尿性 CKD 的患病率和疾病特征。采用随机聚类抽样方法选择患者，对年龄大于 19 岁的患者进行持续尿蛋白试纸检测。在 Medawachchiya 地区（中北部），2600 名患者中有 130 名患有蛋白尿性 CKD，709 名患者中有 68 名患有 Yatinuwara 地区（中部），2844 名患者中有 66 名患有 Hambantota 地区（南部）。这些 CKD 患者的平均年龄在 44 至 52 岁之间。糖尿病和长期高血压是 Yatinuwara 和 Hambantota 地区 CKD 的主要危险因素。在 Medawachchiya 地区，年龄超过 60 岁和务农与蛋白尿性 CKD 密切相关；然而，87%的这些患者的主要危险因素尚不确定。在这些患者中，有 26 人接受了肾活检；组织学显示肾小管间质性疾病。因此，斯里兰卡中北部地区普遍存在病因不明的蛋白尿性 CKD。相比之下，在中央省和南部省，已知的危险因素与 CKD 相关。
