中国中部城市人口中慢性肾脏病和糖尿病肾病的患病率及相关危险因素：一项横断面调查。

Prevalence and risk factors of chronic kidney disease and diabetic kidney disease in a central Chinese urban population: a cross-sectional survey.

机构信息

Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.

出版信息

BMC Nephrol. 2020 Apr 3;21(1):115. doi: 10.1186/s12882-020-01761-5.

DOI:10.1186/s12882-020-01761-5

PMID:32245423

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7118942/

Abstract

BACKGROUND

This study was conducted to evaluate and update the current prevalence of and risk factors for chronic kidney disease (CKD) and diabetic kidney disease (DKD) in a central Chinese urban population.

METHODS

From December 2017 to June 2018, a total of 5231 subjects were randomly enrolled from 3 communities in 3 districts of Zhengzhou. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min.1.73m or urinary albumin to creatinine ratio ≥ 30 mg/g (albuminuria). Diabetic subjects with systolic blood pressure > 140 mmHg, albuminuria or an eGFR less than 60 mL/min/1.73 m were classified as having DKD. Participants completed a questionnaire assessing lifestyle and relevant medical history, and blood and urine specimens were taken. Serum creatinine, uric acid, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein and urinary albumin were assessed. The age- and sex-adjusted prevalences of CKD and DKD were calculated, and risk factors associated with the presence of reduced eGFR, albuminuria, DKD, severity of albuminuria and progression of reduced renal function were analyzed by binary and ordinal logistic regression.

RESULTS

The overall adjusted prevalence of CKD was 16.8% (15.8-17.8%) and that of DKD was 3.5% (3.0-4.0%). Decreased renal function was detected in 132 participants (2.9, 95% confidence interval [CI]: 2.5-3.2%), whereas albuminuria was found in 858 participants (14.9, 95% CI: 13.9-15.9%). In all participants with diabetes, the prevalence of reduced eGFR was 6.3% (95% CI = 3.9-8.6%) and that of albuminuria was 45.3% (95% CI = 40.4-50.1%). The overall prevalence of CKD in participants with diabetes was 48.0% (95% CI = 43.1-52.9%). The results of the binary and ordinal logistic regression indicated that the factors independently associated with a higher risk of reduced eGFR and albuminuria were older age, sex, smoking, alcohol consumption, overweight, obesity, diabetes, hypertension, dyslipidemia and hyperuricemia.

CONCLUSIONS

Our study shows the current prevalence of CKD and DKD in residents of Central China. The high prevalence suggests an urgent need to implement interventions to relieve the high burden of CKD and DKD in China.

摘要

背景

本研究旨在评估和更新中国中部城市人群中慢性肾脏病（CKD）和糖尿病肾病（DKD）的患病率及相关危险因素。

方法

2017 年 12 月至 2018 年 6 月，从郑州 3 个区的 3 个社区中随机抽取 5231 名受试者。CKD 的定义为估算肾小球滤过率（eGFR）<60ml/min·1.73m2或尿白蛋白与肌酐比值≥30mg/g（白蛋白尿）。收缩压>140mmHg、白蛋白尿或 eGFR 低于 60ml/min·1.73m2的糖尿病患者被归类为 DKD。参与者完成了一份评估生活方式和相关医疗史的问卷，并采集了血液和尿液样本。检测血清肌酐、尿酸、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白和尿白蛋白。计算年龄和性别校正后的 CKD 和 DKD 患病率，并通过二项和有序逻辑回归分析与 eGFR 降低、白蛋白尿、DKD、白蛋白尿严重程度和肾功能下降相关的危险因素。

结果

总体校正后的 CKD 患病率为 16.8%（15.8-17.8%），DKD 患病率为 3.5%（3.0-4.0%）。132 名参与者（2.9%，95%置信区间[CI]：2.5-3.2%）检测到肾功能下降，858 名参与者（14.9%，95%CI：13.9-15.9%）出现白蛋白尿。在所有糖尿病患者中，eGFR 降低的患病率为 6.3%（95%CI=3.9-8.6%），白蛋白尿的患病率为 45.3%（95%CI=40.4-50.1%）。糖尿病患者的总体 CKD 患病率为 48.0%（95%CI=43.1-52.9%）。二项和有序逻辑回归的结果表明，与 eGFR 降低和白蛋白尿风险增加相关的独立因素为年龄较大、性别、吸烟、饮酒、超重、肥胖、糖尿病、高血压、血脂异常和高尿酸血症。