Aumann Nicole, Baumeister Sebastian E, Rettig Rainer, Lieb Wolfgang, Werner André, Döring Angela, Peters Annette, Koenig Wolfgang, Hannemann Anke, Wallaschofski Henri, Nauck Matthias, Stracke Sylvia, Völzke Henry, Meisinger Christa
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Kidney Blood Press Res. 2015;40(3):231-43. doi: 10.1159/000368499. Epub 2015 May 4.
BACKGROUND/AIMS: Due to the increasing prevalence of risk factors for chronic kidney disease (CKD), kidney dysfunction becomes a major public health problem. We investigated the CKD prevalence and determined to what extent the variation of risk factors explains the different CKD prevalence in Germany.
We analyzed data from 6,054 participants, aged 31 to 82 years, from the Study of Health in Pomerania (SHIP-1) in Northeast Germany and the Cooperative Health Research in the Region of Augsburg (KORA F4) Study in Southern Germany. Regional differences in selected percentiles corresponding to the cutpoints for estimated glomerular filtration rate (eGFR, <60 ml/min per 1.73 m(2)) and albumin-to-creatinine ratio (ACR, ≥30 mg/g) were tested using quantile regression models that adjusted for CKD risk factors.
The prevalence of decreased eGFRcreatinine-cystatinC (5.9 vs. 3.1 %, p <0.001) and albuminuria (20.2 vs. 8.8 %, p<0.001) were higher in SHIP-1 than in KORA F4. The differential distribution of risk factors explained 18-21% of the regional differences of decreased eGFRcreatinine-cystatinC and high ACR.
The CKD prevalence is higher in Northeast than in Southern Germany. Differences in the prevalence of risk factors partly explain the higher disease burden of CKD in Northeast than in Southern Germany.
背景/目的：由于慢性肾脏病（CKD）危险因素的患病率不断上升，肾功能不全已成为一个主要的公共卫生问题。我们调查了德国CKD的患病率，并确定危险因素的差异在多大程度上解释了德国不同地区CKD患病率的差异。
我们分析了来自德国东北部波美拉尼亚健康研究（SHIP-1）和德国南部奥格斯堡地区合作健康研究（KORA F4）的6054名年龄在31至82岁之间参与者的数据。使用经CKD危险因素校正的分位数回归模型，对与估计肾小球滤过率（eGFR，<60 ml/min per 1.73 m(2)）和白蛋白与肌酐比值（ACR，≥30 mg/g）切点相对应的选定百分位数的地区差异进行了检验。
SHIP-1研究中eGFR肌酐-胱抑素C降低（5.9%对3.1%，p<0.001）和蛋白尿（20.2%对8.8%，p<0.001）的患病率高于KORA F4研究。危险因素的差异分布解释了eGFR肌酐-胱抑素C降低和ACR升高的地区差异的18-21%。
德国东北部CKD患病率高于南部。危险因素患病率的差异部分解释了德国东北部CKD疾病负担高于南部的原因。
