Brück Katharina, Stel Vianda S, Gambaro Giovanni, Hallan Stein, Völzke Henry, Ärnlöv Johan, Kastarinen Mika, Guessous Idris, Vinhas José, Stengel Bénédicte, Brenner Hermann, Chudek Jerzy, Romundstad Solfrid, Tomson Charles, Gonzalez Alfonso Otero, Bello Aminu K, Ferrieres Jean, Palmieri Luigi, Browne Gemma, Capuano Vincenzo, Van Biesen Wim, Zoccali Carmine, Gansevoort Ron, Navis Gerjan, Rothenbacher Dietrich, Ferraro Pietro Manuel, Nitsch Dorothea, Wanner Christoph, Jager Kitty J
European Renal Association-European Dialysis and Transplant Association Registry, Department of Medical Informatics, Amsterdam Medical Center, Amsterdam, The Netherlands;
Division of Nephrology and Dialysis, Columbus-Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy;
J Am Soc Nephrol. 2016 Jul;27(7):2135-47. doi: 10.1681/ASN.2015050542. Epub 2015 Dec 23.
CKD prevalence estimation is central to CKD management and prevention planning at the population level. This study estimated CKD prevalence in the European adult general population and investigated international variation in CKD prevalence by age, sex, and presence of diabetes, hypertension, and obesity. We collected data from 19 general-population studies from 13 European countries. CKD stages 1-5 was defined as eGFR<60 ml/min per 1.73 m(2), as calculated by the CKD-Epidemiology Collaboration equation, or albuminuria >30 mg/g, and CKD stages 3-5 was defined as eGFR<60 ml/min per 1.73 m(2) CKD prevalence was age- and sex-standardized to the population of the 27 Member States of the European Union (EU27). We found considerable differences in both CKD stages 1-5 and CKD stages 3-5 prevalence across European study populations. The adjusted CKD stages 1-5 prevalence varied between 3.31% (95% confidence interval [95% CI], 3.30% to 3.33%) in Norway and 17.3% (95% CI, 16.5% to 18.1%) in northeast Germany. The adjusted CKD stages 3-5 prevalence varied between 1.0% (95% CI, 0.7% to 1.3%) in central Italy and 5.9% (95% CI, 5.2% to 6.6%) in northeast Germany. The variation in CKD prevalence stratified by diabetes, hypertension, and obesity status followed the same pattern as the overall prevalence. In conclusion, this large-scale attempt to carefully characterize CKD prevalence in Europe identified substantial variation in CKD prevalence that appears to be due to factors other than the prevalence of diabetes, hypertension, and obesity.
慢性肾脏病(CKD)患病率估计是人群层面CKD管理和预防规划的核心。本研究估计了欧洲成年普通人群中的CKD患病率,并调查了CKD患病率在年龄、性别以及糖尿病、高血压和肥胖症存在与否方面的国际差异。我们从13个欧洲国家的19项普通人群研究中收集了数据。CKD 1-5期定义为根据CKD流行病学协作组方程计算的估算肾小球滤过率(eGFR)<60 ml/(min·1.73 m²),或蛋白尿>30 mg/g,CKD 3-5期定义为eGFR<60 ml/(min·1.73 m²)。CKD患病率按年龄和性别标准化为欧盟27个成员国(EU27)的人口。我们发现,欧洲各研究人群在CKD 1-5期和CKD 3-5期患病率方面存在显著差异。调整后的CKD 1-5期患病率在挪威为3.31%(95%置信区间[95%CI],3.30%至3.33%),在德国东北部为17.3%(95%CI,16.5%至18.1%)。调整后的CKD 3-5期患病率在意大利中部为1.0%(95%CI,0.7%至1.3%),在德国东北部为5.9%(95%CI,5.2%至6.6%)。按糖尿病、高血压和肥胖状况分层的CKD患病率变化与总体患病率遵循相同模式。总之,这项在欧洲仔细描述CKD患病率的大规模尝试发现,CKD患病率存在显著差异,这似乎是由糖尿病、高血压和肥胖症患病率以外的因素导致的。