icddr,b, Dhaka, Bangladesh.
Institute for Social Science Research, The University of Queensland, Brisbane, Qld, Australia.
PLoS One. 2019 Apr 4;14(4):e0214568. doi: 10.1371/journal.pone.0214568. eCollection 2019.
The objective of this study was to describe the age and sex-specific prevalence of renal insufficiency, and observe its trends over a decade at an urban Bangladesh setup.
This was a cross-sectional study, in which we observed the Estimated Glomerular Filtration Rate (eGFR) of 218,888 adults, aged ≥19 years, who had submitted their blood specimen to the Clinical Biochemistry Laboratory of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) during the years 2006-2015. We applied CKD-EPI definition in estimating eGFR using their age-and sex-specific serum creatinine concentrations. Based on the eGFR, we classified the population into five stages of renal insufficiency (stage-1 to stage-5), at age intervals of five-years. Data were analysed using the Linear Regression and Multinomial Logistic Regression models.
Females constituted 43% (n = 94,931) of the study population; and 34% (n = 42,576) of the males and 31% (n = 29,830) of the females had their serum creatinine concentrations above the upper limit of the laboratory reference cut-off. The overall prevalence of stage-2 to stage-5 renal insufficiency were 24% (n = 52,126), 17% (n = 38,539), 8% (n = 16,504) and 6% (n = 12,665) respectively; the prevalence were 23% (n = 1,890), 19% (n = 1,579), 9% (n = 769) and 9% (n = 770) respectively in 2006, and 24% (n = 10,062), 17% (n = 6,903), 6% (n = 2,537) and 5% (n = 1,924) respectively in 2015. The prevalence was higher among the females. At least 2% of the adults, younger than <44 years, had stage-4 and stage-5 in 2015. The age-adjusted eGFR was significantly lower among the post-menopausal females (aged ≥46 y) compared to the same age group males (64.08±10.83 vs. 66.83±10.41 mL/min/1.73 m2; p<0.001). Compared to 2006, the number of individuals with renal insufficiency (stage 2 and above) had increased at least two times, irrespective of age, in 2015. A single year of increase in the age was significantly associated with 1.32 unit reductions in the eGFR; and the reductions were higher for females who also had higher odds of renal insufficiency stages-2 and beyond.
This study observed high prevalence of stage-2 to stage-5 renal insufficiency in Bangladeshi populations, irrespective of age, and especially among the females.
本研究旨在描述肾功能不全在年龄和性别上的具体流行情况，并观察其在孟加拉国一个城市环境下十年间的变化趋势。
这是一项横断面研究，我们观察了 218888 名年龄≥19 岁的成年人的估算肾小球滤过率（eGFR），这些成年人在 2006 年至 2015 年间向孟加拉国际腹泻病研究中心（icddr,b）的临床生化实验室提交了血样。我们应用 CKD-EPI 定义，根据其年龄和性别特异性血清肌酐浓度来估计 eGFR。根据 eGFR，我们将人群分为五个肾功能不全阶段（1 期至 5 期），每五年为一个年龄间隔。使用线性回归和多项逻辑回归模型对数据进行分析。
女性占研究人群的 43%（n=94931）；男性中有 34%（n=42576）和女性中有 31%（n=29830）的血清肌酐浓度超过实验室参考截止值上限。总体来看，2 期至 5 期肾功能不全的患病率分别为 24%（n=52126）、17%（n=38539）、8%（n=16504）和 6%（n=12665）；2006 年时，患病率分别为 23%（n=1890）、19%（n=1579）、9%（n=769）和 9%（n=770），2015 年时，患病率分别为 24%（n=10062）、17%（n=6903）、6%（n=2537）和 5%（n=1924）。女性的患病率更高。在 2015 年，至少有 2%的<44 岁的成年人处于 4 期和 5 期。与同年龄组男性相比（64.08±10.83 vs. 66.83±10.41 mL/min/1.73 m2；p<0.001），绝经后女性（≥46 岁）的年龄校正后 eGFR 明显较低。与 2006 年相比，2015 年无论年龄大小，肾功能不全（2 期及以上）患者的数量至少增加了两倍。年龄每增加一年，eGFR 就会减少 1.32 个单位；而女性的 eGFR 减少幅度更高，她们也更有可能出现 2 期及以上的肾功能不全。
本研究观察到孟加拉国人群中存在较高的 2 期至 5 期肾功能不全流行率，且不论年龄大小，女性的发病率更高。
