美国西班牙裔/拉丁裔人群中慢性肾脏病的患病率及其相关因素
Prevalence and Correlates of CKD in Hispanics/Latinos in the United States.
作者信息
Ricardo Ana C, Flessner Michael F, Eckfeldt John H, Eggers Paul W, Franceschini Nora, Go Alan S, Gotman Nathan M, Kramer Holly J, Kusek John W, Loehr Laura R, Melamed Michal L, Peralta Carmen A, Raij Leopoldo, Rosas Sylvia E, Talavera Gregory A, Lash James P
机构信息
Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
出版信息
Clin J Am Soc Nephrol. 2015 Oct 7;10(10):1757-66. doi: 10.2215/CJN.02020215. Epub 2015 Sep 28.
BACKGROUND AND OBJECTIVES
The prevalence of ESRD among Hispanics/Latinos is 2-fold higher than in non-Hispanic whites. However, little is known about the prevalence of earlier stages of CKD among Hispanics/Latinos. This study estimated the prevalence of CKD in US Hispanics/Latinos.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a cross-sectional study of 15,161 US Hispanic/Latino adults of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American backgrounds enrolled in the multicenter, prospective, population-based Hispanic Community Health Study/Study of Latinos (HCHS/SOL). In addition, the prevalence of CKD in Hispanics/Latinos was compared with other racial/ethnic groups in the 2007-2010 National Health and Nutrition Examination Survey (NHANES). Prevalent CKD was defined as an eGFR <60 ml/min per 1.73 m(2) (estimated with the 2012 Chronic Kidney Disease Epidemiology Collaboration eGFR creatinine-cystatin C equation) or albuminuria based on sex-specific cut points determined at a single point in time.
RESULTS
The overall prevalence of CKD among Hispanics/Latinos was 13.7%. Among women, the prevalence of CKD was 13.0%, and it was lowest in persons with South American background (7.4%) and highest (16.6%) in persons with Puerto Rican background. In men, the prevalence of CKD was 15.3%, and it was lowest (11.2%) in persons with South American background and highest in those who identified their Hispanic background as "other" (16.0%). The overall prevalence of CKD was similar in HCHS/SOL compared with non-Hispanic whites in NHANES. However, prevalence was higher in HCHS/SOL men and lower in HCHS/SOL women versus NHANES non-Hispanic whites. Low income, diabetes mellitus, hypertension, and cardiovascular disease were each significantly associated with higher risk of CKD.
CONCLUSIONS
Among US Hispanic/Latino adults, there was significant variation in CKD prevalence among Hispanic/Latino background groups, and CKD was associated with established cardiovascular risk factors.
背景与目的
西班牙裔/拉丁裔人群中终末期肾病（ESRD）的患病率是非西班牙裔白人的两倍。然而，对于西班牙裔/拉丁裔人群中慢性肾脏病（CKD）早期阶段的患病率知之甚少。本研究估算了美国西班牙裔/拉丁裔人群中CKD的患病率。
设计、地点、参与者及测量方法：这是一项横断面研究，研究对象为15161名具有古巴、多米尼加、墨西哥、波多黎各、中美洲和南美洲背景的美国西班牙裔/拉丁裔成年人，他们参与了多中心、前瞻性、基于人群的西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）。此外，将HCHS/SOL中西班牙裔/拉丁裔人群的CKD患病率与2007 - 2010年国家健康与营养检查调查（NHANES）中的其他种族/族裔群体进行比较。CKD患病率定义为估算肾小球滤过率（eGFR）<60 ml/（min·1.73 m²）（使用2012年慢性肾脏病流行病学协作组eGFR肌酐 - 胱抑素C方程估算）或根据某一时刻确定的性别特异性切点判断的蛋白尿。
结果
西班牙裔/拉丁裔人群中CKD的总体患病率为13.7%。在女性中，CKD患病率为13.0%，以南美背景人群最低（7.4%），波多黎各背景人群最高（16.6%）。在男性中，CKD患病率为15.3%，以南美背景人群最低（11.2%），将自己的西班牙裔背景认定为“其他”的人群最高（16.0%）。与NHANES中的非西班牙裔白人相比，HCHS/SOL中CKD的总体患病率相似。然而，与NHANES中的非西班牙裔白人相比，HCHS/SOL中的男性患病率较高，女性患病率较低。低收入、糖尿病、高血压和心血管疾病均与CKD风险较高显著相关。
结论
在美国西班牙裔/拉丁裔成年人中，不同西班牙裔/拉丁裔背景群体的CKD患病率存在显著差异，且CKD与已确定的心血管危险因素相关。
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