School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK.
BMC Nephrol. 2013 Feb 25;14:49. doi: 10.1186/1471-2369-14-49.
There is concern that not all cases of chronic kidney disease (CKD) are known to general practitioners, leading to an underestimate of its true prevalence. We carried out this study to develop a model to predict the prevalence of CKD using a large English primary care dataset which includes previously undiagnosed cases of CKD.
Cross-sectional analysis of data from the Quality Improvement in CKD trial, a representative sample of 743 935 adults in England aged 18 and over. We created multivariable logistic regression models to identify important predictive factors.
A prevalence of 6.76% was recorded in our sample, compared to a national prevalence of 4.3%. Increasing age, female gender and cardiovascular disease were associated with a significantly increased prevalence of CKD (p < 0.001 for all). Age had a complex association with CKD. Cardiovascular disease was a stronger predictive factor in younger than in older patients. For example, hypertension has an odds ratio of 2.02 amongst patients above average and an odds ratio of 3.91 amongst patients below average age.
In England many cases of CKD remain undiagnosed. It is possible to use the results of this study to identify areas with high levels of undiagnosed CKD and groups at particular risk of having CKD.
Current Controlled Trials ISRCTN: ISRCTN56023731. Note that this study reports the results of a cross-sectional analysis of data from this trial.
全科医生可能并未发现所有慢性肾脏病（CKD）病例，这导致其实际患病率被低估。我们开展了这项研究，旨在利用包含先前未诊断 CKD 病例的大型英国初级保健数据集，开发一种预测 CKD 患病率的模型。
对英格兰年龄在 18 岁及以上的 743935 名成年人的代表性样本进行了“CKD 质量改进”试验的数据的横断面分析。我们创建了多变量逻辑回归模型，以确定重要的预测因素。
在我们的样本中记录到的患病率为 6.76%，而全国的患病率为 4.3%。年龄增长、女性和心血管疾病与 CKD 的患病率显著增加相关（p<0.001）。年龄与 CKD 之间存在复杂的关联。心血管疾病在年轻患者中的预测因素比老年患者更强。例如，高血压在平均年龄以上患者中的比值比为 2.02，在平均年龄以下患者中的比值比为 3.91。
在英格兰，许多 CKD 病例仍未被诊断。利用这项研究的结果，可以识别出未确诊 CKD 水平较高的地区和有特定 CKD 风险的人群。
当前对照试验 ISRCTN：ISRCTN56023731。请注意，这项研究报告了对来自该试验的数据进行横断面分析的结果。
