Provenzano Michele, Mancuso Cinzia, Garofalo Carlo, De Nicola Luca, Andreucci Michele
Nephrology Unit of "Magna Graecia" University of Catanzaro, Italy.
Nephrology Unit of University of Campania "L. Vanvitelli" - Naples, Italy.
G Ital Nefrol. 2019 Apr;36(2).
Chronic Kidney Disease (CKD) is a major risk factor for mortality and morbidity, as well as a growing public health problem. Several studies describe the epidemiology of CKD (i.e. prevalence, incidence) by examining short time intervals. Conversely, the trend of epidemiology over time has not been well investigated, although it may provide useful information on how to improve prevention measures and the allocation of economic resources. Our aim here is to describe the main aspects of the epidemiology of CKD by focusing on its temporal variation. The global incidence of CKD has increased by 89% in the last 27 years, primarily due to the improved socio-demographic index and life-expectancy. Prevalence has similarly increased by 87% over the same period. Mortality rate has however decreased over the last decades, both in the general and CKD populations, due to a reduction in cardiovascular and infectious disease mortality. It is important to emphasize that the upward trend of incidence and prevalence of CKD can be explained by the ageing of the population, as well as by the increase in the prevalence of comorbidities such as hypertension, diabetes and obesity. It seems hard to compare trends between Italy and other countries because of the different methods used to assess epidemiologic measures. The creation of specific CKD Registries in Italy appears therefore necessary to monitor the trend of CKD and its comorbidities over time.
慢性肾脏病（CKD）是导致死亡和发病的主要风险因素，也是一个日益严重的公共卫生问题。多项研究通过考察短时间间隔来描述CKD的流行病学情况（即患病率、发病率）。相反，尽管流行病学随时间的变化趋势可能会为如何改进预防措施和经济资源分配提供有用信息，但这方面的研究还很不足。我们在此的目的是通过关注CKD流行病学的时间变化来描述其主要方面。在过去27年中，全球CKD发病率增长了89%，这主要归因于社会人口统计学指标和预期寿命的改善。同期患病率也同样增长了87%。然而，由于心血管疾病和传染病死亡率的下降，在过去几十年中，一般人群和CKD人群的死亡率均有所降低。必须强调的是，CKD发病率和患病率的上升趋势可归因于人口老龄化，以及高血压、糖尿病和肥胖等合并症患病率的增加。由于评估流行病学指标所采用的方法不同，意大利与其他国家之间的趋势似乎难以比较。因此，在意大利建立特定的CKD登记系统对于长期监测CKD及其合并症的趋势显得很有必要。
