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高血压患者慢性肾脏病的隐匿患病率:基层医疗保健的战略作用。

Hidden prevalence of chronic kidney disease in hypertensive patients: the strategic role of primary health care.

机构信息

Department of Nutrition and Health, Federal University of Viçosa, Brazil.

Department of Nursing and Medicine, Federal University of Viçosa, Brazil.

出版信息

Public Health. 2016 Nov;140:250-257. doi: 10.1016/j.puhe.2016.02.029. Epub 2016 Mar 29.

Abstract

OBJECTIVE

To identify the hidden prevalence of chronic kidney disease (CKD) in hypertensive patients.

STUDY DESIGN

Cross-sectional study of individuals with systemic arterial hypertension (SAH) who were registered for primary health care (PHC).

METHODS

In total, 293 individuals participated. Data were collected through interviews, as well as biochemical and anthropometric assessments. The CKD-EPI formula was used to identify the occurrence of CKD. Pearson's chi-squared test or Fisher's exact test were used to compare proportions. Prevalence ratios were estimated with a confidence interval of 95% for associations between the explanatory variables and CKD.

RESULTS

Most of the individuals assessed were female (74%), elderly (69%), with a low income (90%), low education levels (84%) and overweight (66.9%). A CKD prevalence of 38.6% (95% CI: 33.0-44.2) was found and approximately 14% were at an advanced stage of the disease. Upon comparison of the variables in the different stages of CKD, statistically significant association could be suggested between CKD and age, education, alcohol intake, overweight individuals, cardiovascular risk, abnormal creatinine and abnormal microalbuminuria. When the prevalence ratio was assessed, association could be suggested between CKD and age, and CKD and creatinine.

CONCLUSION

The high hidden prevalence of CKD confirms the need to train health professionals involved in the treatment of SAH through PHC, enabling the prevention and diagnosis of CKD in its early stages.

摘要

目的

确定高血压患者中慢性肾脏病(CKD)的隐匿患病率。

研究设计

对接受初级卫生保健(PHC)登记的全身性动脉高血压(SAH)患者进行横断面研究。

方法

共有 293 人参与。通过访谈以及生化和人体测量评估收集数据。使用 CKD-EPI 公式确定 CKD 的发生。采用皮尔逊卡方检验或 Fisher 确切检验比较比例。使用 95%置信区间估计解释变量与 CKD 之间关联的患病率比。

结果

评估的大多数个体为女性(74%)、老年人(69%)、收入低(90%)、教育程度低(84%)和超重(66.9%)。发现 CKD 患病率为 38.6%(95%CI:33.0-44.2),约 14%处于疾病晚期。在比较 CKD 不同阶段的变量时,可提示 CKD 与年龄、教育程度、饮酒、超重、心血管风险、肌酐异常和微量白蛋白尿异常之间存在统计学显著关联。当评估患病率比时,可提示 CKD 与年龄和 CKD 与肌酐之间存在关联。

结论

CKD 的高隐匿患病率证实了需要通过 PHC 培训参与 SAH 治疗的卫生专业人员,以便在早期预防和诊断 CKD。

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