Ferguson T S, Tulloch-Reid M K, Younger-Coleman N O, Wright-Pascoe R A, Boyne M S, Soyibo A K, Wilks R J
Tropical Medicine Research Institute (Epidemiology Research Unit), The University of the West Indies, Kingston 7, Jamaica.
Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica.
West Indian Med J. 2015 Jun;64(3):201-8. doi: 10.7727/wimj.2014.084. Epub 2015 May 4.
To estimate the prevalence of chronic kidney disease (CKD) among patients attending the University Hospital of the West Indies (UHWI) Diabetes Clinic and to determine the proportion of patients at high risk for adverse outcomes.
We conducted a cross-sectional study among patients attending the UHWI Diabetes Clinic between 2009 and 2010. Trained nurses administered a questionnaire, reviewed dockets, and performed urinalyses. Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Albuminuria was assessed using urine test strips for protein and microalbumin. Chronic kidney disease was defined as an eGFR < 60 ml/min/1.73m2 or albuminuria ≥ 30 mg/g creatinine. Risk of adverse outcome (all-cause mortality, cardiovascular disease and kidney failure) was determined using the Kidney Disease: Improving Global Outcome (KDIGO) 2012 prognosis grid.
Participants included 100 women and 32 men (mean age, 55.4 ± 12.9 years, mean duration of diabetes, 16.7 ± 11.7 years). Twenty-two per cent of participants had eGFR < 60 ml/min/1.73m2. Moderate albuminuria (30-300 mg/g) was present in 20.5% of participants and severe albuminuria (> 300 mg/g) in 62.1%. Overall prevalence of CKD was 86.3% (95%CI 80.4%, 92.2%). Based on KDIGO risk categories, 50.8% were at high risk and 17.4% at very high risk of adverse outcomes.
Most patients at the UHWI Diabetes Clinic had CKD and were at high or very high risk of adverse outcomes. Further studies to determine the burden of CKD in other clinical settings and to identify the best strategies for preventing adverse outcomes in developing countries need to be conducted.
评估西印度群岛大学医院（UHWI）糖尿病诊所患者中慢性肾脏病（CKD）的患病率，并确定不良结局高危患者的比例。
我们于2009年至2010年期间对UHWI糖尿病诊所的患者进行了一项横断面研究。经过培训的护士发放问卷、查阅病历并进行尿液分析。使用慢性肾脏病流行病学协作组（CKD-EPI）方程计算估计肾小球滤过率（eGFR）。使用尿蛋白和微量白蛋白试纸评估蛋白尿。慢性肾脏病定义为eGFR<60 ml/min/1.73m²或蛋白尿≥30 mg/g肌酐。使用《肾脏病：改善全球预后》（KDIGO）2012预后评估表确定不良结局（全因死亡率、心血管疾病和肾衰竭）的风险。
参与者包括100名女性和32名男性（平均年龄55.4±12.9岁，平均糖尿病病程16.7±11.7年）。22%的参与者eGFR<60 ml/min/1.73m²。20.五%的参与者存在中度蛋白尿（30 - 300 mg/g），62.一%的参与者存在重度蛋白尿（>300 mg/g）。CKD的总体患病率为86.三%（95%CI 80.四%，92.二%）。根据KDIGO风险分类，50.八%的患者处于高危，17.四%的患者处于极高危不良结局风险。
UHWI糖尿病诊所的大多数患者患有CKD，且处于不良结局的高风险或极高风险。需要开展进一步研究以确定其他临床环境中CKD的负担，并确定发展中国家预防不良结局的最佳策略。
