University at Buffalo, NY, USA.
Adv Chronic Kidney Dis. 2011 Nov;18(6):400-5. doi: 10.1053/j.ackd.2011.10.001.
CKD is a complex comorbid condition with multiple manifestations. It is closely linked with cardiovascular disease and has a very high mortality rate. Currently, it consumes 28% of Medicare expenditures. Complications of CKD include hypertension, diabetes, dyslipidemia, cardiovascular disease, anemia, and bone and mineral disorders. It is underrecognized and underdiagnosed in primary care offices. There is strong evidence that controlling blood pressure, blood glucose, and use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in albuminuric patients, as well as referral to the nephrologist when glomerular filtration rate is <30 mL/min/1.73 m(2), is associated with lower mortality, better access to kidney transplantation, improved management of comorbidities, and less frequent use of catheters for dialysis and to lower mortality.
慢性肾脏病是一种具有多种表现的复杂合并症。它与心血管疾病密切相关，死亡率非常高。目前，它消耗了 28%的医疗保险支出。慢性肾脏病的并发症包括高血压、糖尿病、血脂异常、心血管疾病、贫血和骨与矿物质代谢紊乱。在初级保健机构中，慢性肾脏病常常被漏诊和误诊。有强有力的证据表明，在白蛋白尿患者中控制血压、血糖以及使用血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂，以及当肾小球滤过率<30 mL/min/1.73 m(2)时转至肾病专家处，可降低死亡率，提高接受肾移植的机会，改善合并症的管理，并减少用于透析和降低死亡率的导管的使用。
