Brück Katharina, Jager Kitty J, Dounousi Evangelia, Kainz Alexander, Nitsch Dorothea, Ärnlöv Johan, Rothenbacher Dietrich, Browne Gemma, Capuano Vincenzo, Ferraro Pietro Manuel, Ferrieres Jean, Gambaro Giovanni, Guessous Idris, Hallan Stein, Kastarinen Mika, Navis Gerjan, Gonzalez Alfonso Otero, Palmieri Luigi, Romundstad Solfrid, Spoto Belinda, Stengel Benedicte, Tomson Charles, Tripepi Giovanni, Völzke Henry, Wiȩcek Andrzej, Gansevoort Ron, Schöttker Ben, Wanner Christoph, Vinhas Jose, Zoccali Carmine, Van Biesen Wim, Stel Vianda S
ERA-EDTA Registry, Amsterdam Medical Center, Amsterdam, The Netherlands.
Department of Nephrology, Medical School, University of Ioannina, Ioannina, Greece.
Nephrol Dial Transplant. 2015 Aug;30 Suppl 4(Suppl 4):iv6-16. doi: 10.1093/ndt/gfv131.
Many publications report the prevalence of chronic kidney disease (CKD) in the general population. Comparisons across studies are hampered as CKD prevalence estimations are influenced by study population characteristics and laboratory methods.
For this systematic review, two researchers independently searched PubMed, MEDLINE and EMBASE to identify all original research articles that were published between 1 January 2003 and 1 November 2014 reporting the prevalence of CKD in the European adult general population. Data on study methodology and reporting of CKD prevalence results were independently extracted by two researchers.
We identified 82 eligible publications and included 48 publications of individual studies for the data extraction. There was considerable variation in population sample selection. The majority of studies did not report the sampling frame used, and the response ranged from 10 to 87%. With regard to the assessment of kidney function, 67% used a Jaffe assay, whereas 13% used the enzymatic assay for creatinine determination. Isotope dilution mass spectrometry calibration was used in 29%. The CKD-EPI (52%) and MDRD (75%) equations were most often used to estimate glomerular filtration rate (GFR). CKD was defined as estimated GFR (eGFR) <60 mL/min/1.73 m(2) in 92% of studies. Urinary markers of CKD were assessed in 60% of the studies. CKD prevalence was reported by sex and age strata in 54 and 50% of the studies, respectively. In publications with a primary objective of reporting CKD prevalence, 39% reported a 95% confidence interval.
The findings from this systematic review showed considerable variation in methods for sampling the general population and assessment of kidney function across studies reporting CKD prevalence. These results are utilized to provide recommendations to help optimize both the design and the reporting of future CKD prevalence studies, which will enhance comparability of study results.
许多出版物报道了普通人群中慢性肾脏病（CKD）的患病率。由于CKD患病率估计受研究人群特征和实验室方法的影响，跨研究比较受到阻碍。
对于本系统评价，两名研究人员独立检索了PubMed、MEDLINE和EMBASE，以识别2003年1月1日至2014年11月1日期间发表的所有报告欧洲成年普通人群中CKD患病率的原创研究文章。两名研究人员独立提取关于研究方法和CKD患病率结果报告的数据。
我们识别出82篇符合条件的出版物，并纳入48篇个体研究出版物进行数据提取。人群样本选择存在相当大的差异。大多数研究未报告所使用的抽样框架，应答率在10%至87%之间。关于肾功能评估，67%使用碱性苦味酸法，而13%使用酶法测定肌酐。29%使用同位素稀释质谱校准。CKD-EPI方程（52%）和MDRD方程（75%）最常用于估计肾小球滤过率（GFR）。92%的研究将CKD定义为估计肾小球滤过率（eGFR）<60 mL/min/1.73 m²。60%的研究评估了CKD的尿标志物。分别有54%和50%的研究按性别和年龄层报告了CKD患病率。在以报告CKD患病率为主要目的的出版物中，39%报告了95%置信区间。
本系统评价的结果表明，在报告CKD患病率的研究中，普通人群抽样方法和肾功能评估方法存在相当大的差异。这些结果用于提供建议，以帮助优化未来CKD患病率研究的设计和报告，这将提高研究结果的可比性。
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