中国慢性肾脏病患病率的横断面调查。

Prevalence of chronic kidney disease in China: a cross-sectional survey.

机构信息

Peking University Institute of Nephrology, Division of Nephrology, Peking University First Hospital, Beijing, China.

出版信息

Lancet. 2012 Mar 3;379(9818):815-22. doi: 10.1016/S0140-6736(12)60033-6.

DOI:10.1016/S0140-6736(12)60033-6

PMID:22386035

Abstract

BACKGROUND

The prevalence of chronic kidney disease is high in developing countries. However, no national survey of chronic kidney disease has been done incorporating both estimated glomerular filtration rate (eGFR) and albuminuria in a developing country with the economic diversity of China. We aimed to measure the prevalence of chronic kidney disease in China with such a survey.

METHODS

We did a cross-sectional survey of a nationally representative sample of Chinese adults. Chronic kidney disease was defined as eGFR less than 60 mL/min per 1·73 m(2) or the presence of albuminuria. Participants completed a lifestyle and medical history questionnaire and had their blood pressure measured, and blood and urine samples taken. Serum creatinine was measured and used to estimate glomerular filtration rate. Urinary albumin and creatinine were tested to assess albuminuria. The crude and adjusted prevalence of indicators of kidney damage were calculated and factors associated with the presence of chronic kidney disease analysed by logistic regression.

FINDINGS

50,550 people were invited to participate, of whom 47,204 agreed. The adjusted prevalence of eGFR less than 60 mL/min per 1·73 m(2) was 1·7% (95% CI 1·5-1·9) and of albuminuria was 9·4% (8·9-10·0). The overall prevalence of chronic kidney disease was 10·8% (10·2-11·3); therefore the number of patients with chronic kidney disease in China is estimated to be about 119·5 million (112·9-125·0 million). In rural areas, economic development was independently associated with the presence of albuminuria. The prevalence of chronic kidney disease was high in north (16·9% [15·1-18·7]) and southwest (18·3% [16·4-20·4]) regions compared with other regions. Other factors independently associated with kidney damage were age, sex, hypertension, diabetes, history of cardiovascular disease, hyperuricaemia, area of residence, and economic status.

INTERPRETATION

Chronic kidney disease has become an important public health problem in China. Special attention should be paid to residents in economically improving rural areas and specific geographical regions in China.

FUNDING

The Ministry of Science and Technology (China); the Science and Technology Commission of Shanghai; the National Natural Science Foundation of China; the Department of Health, Jiangsu Province; the Sichuan Science and Technology Department; the Ministry of Education (China); the International Society of Nephrology Research Committee; and the China Health and Medical Development Foundation.

摘要

背景

发展中国家慢性肾脏病的患病率很高。然而，在经济多样化的中国，还没有一项将肾小球滤过率估计值（eGFR）和白蛋白尿纳入其中的全国性慢性肾脏病调查。我们旨在通过这样的调查来衡量中国慢性肾脏病的患病率。

方法

我们对中国具有代表性的成年人群进行了横断面调查。慢性肾脏病的定义为 eGFR 小于 60 mL/min/1.73 m²或存在白蛋白尿。参与者完成了生活方式和病史问卷，并测量了血压，采集了血液和尿液样本。血清肌酐用于估计肾小球滤过率。检测尿白蛋白和肌酐以评估白蛋白尿。通过逻辑回归分析计算了肾脏损伤指标的粗患病率和调整后患病率，并分析了与慢性肾脏病存在相关的因素。

结果

共邀请了 50550 人参加，其中 47204 人同意。eGFR 小于 60 mL/min/1.73 m²的调整后患病率为 1.7%（95%CI 1.5-1.9），白蛋白尿的患病率为 9.4%（8.9-10.0）。慢性肾脏病的总患病率为 10.8%（10.2-11.3）；因此，中国慢性肾脏病患者的数量估计约为 11.95 亿（11.29 亿-12.50 亿）。在农村地区，经济发展与白蛋白尿的存在独立相关。与其他地区相比，北部（16.9%[15.1-18.7%]）和西南部（18.3%[16.4-20.4%]）地区的慢性肾脏病患病率较高。与肾脏损伤独立相关的其他因素包括年龄、性别、高血压、糖尿病、心血管疾病史、高尿酸血症、居住地和经济状况。