东北埃塞俄比亚成年糖尿病门诊患者慢性肾脏病的患病率和知晓率。
Prevalence and awareness of chronic kidney disease among adult diabetic outpatients in Northeast Ethiopia.
机构信息
Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
BMC Nephrol. 2020 Apr 15;21(1):129. doi: 10.1186/s12882-020-01768-y.
BACKGROUND
Chronic kidney disease (CKD) is a serious complication of diabetes associated with adverse outcomes of renal failure, cardiovascular disease and mortality. Despite this, data regarding the burden and awareness of CKD among adults with diabetes in Sub-Saharan Africa countries are lacking. The aim of this study was, therefore to determine the prevalence and awareness of CKD among diabetic outpatients attending a hospital in Northeast Ethiopia.
METHODS
We conducted a cross-sectional study on 323 diabetic adults at the diabetes clinic of a hospital in Northeast Ethiopia, from February 1 to July 30, 2016. Each patient provided a blood sample for serum creatinine and urine for albuminuria. Glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease (MDRD) equation. CKD was defined as eGFR < 60 ml/min/1.73 m and/or albuminuria. Awareness was defined as a positive response to "Has a doctor or other health care professional ever told you that you had kidney disease?"
RESULTS
Of the 323 patients, 85 (26.3%) had Stage 1-5 CKD, 42 (13.0%) had eGFR < 60 ml/min/1.73m and 58 (18.0%) had albuminuria. In patients with eGFR < 60 ml/min/1.73m (stage 3-5 CKD), serum creatinine was abnormal (> 1.5 mg/dl) in 23.5% and albuminuria was absent in 31.8%. Of the patients with CKD, only 10.6% of them were aware of their CKD. The proportion of patients who were aware of their disease increased with worsening of CKD stages, from 3.4% of with stage 1 to 75.0% with stage 4. Awareness for all individuals with advanced stages of CKD was only 11.9%. Having albuminuria, high serum creatinine, a family history of kidney disease and being obese were significantly associated with CKD awareness.
CONCLUSION
A high prevalence but low awareness of CKD was found in diabetic outpatients attending our clinic in Northeast Ethiopia. Our results highlight the need for more diagnostic strategies for CKD screening among diabetic adults and primary care education on the impact of detecting CKD in the early stage to prevent adverse outcomes and improve diabetes care.
背景
慢性肾脏病（CKD）是糖尿病的一种严重并发症，与肾衰竭、心血管疾病和死亡率等不良结局相关。尽管如此，撒哈拉以南非洲国家成人糖尿病患者的 CKD 负担和认知情况数据仍十分缺乏。因此，本研究旨在确定东北埃塞俄比亚一家医院的糖尿病门诊患者中 CKD 的患病率和认知情况。
方法
我们于 2016 年 2 月 1 日至 7 月 30 日在东北埃塞俄比亚的一家医院的糖尿病门诊对 323 名成年糖尿病患者进行了横断面研究。每位患者均提供了一份血清肌酐血样和一份尿液白蛋白尿样。使用肾脏病饮食改良公式（MDRD）估算肾小球滤过率（eGFR）。CKD 定义为 eGFR<60ml/min/1.73m 且/或白蛋白尿。认知情况定义为对“医生或其他医疗保健专业人员是否曾告诉您患有肾脏疾病？”这一问题的阳性回答。
结果
323 名患者中，85 名（26.3%）患有 1-5 期 CKD，42 名（13.0%）eGFR<60ml/min/1.73m，58 名（18.0%）白蛋白尿。在 eGFR<60ml/min/1.73m（3-5 期 CKD）的患者中，23.5%血清肌酐异常（>1.5mg/dl），31.8%白蛋白尿缺失。CKD 患者中仅有 10.6%知晓自己的 CKD。随着 CKD 分期恶化，患者的疾病认知率逐渐升高，从 1 期的 3.4%上升至 4 期的 75.0%。在所有患有晚期 CKD 的患者中，仅有 11.9%知晓自己的疾病。存在白蛋白尿、高血清肌酐、肾脏病家族史和肥胖与 CKD 认知显著相关。
结论
在我们东北埃塞俄比亚的诊所就诊的糖尿病患者中，CKD 的患病率较高，但认知率较低。我们的研究结果强调了在糖尿病成人中实施更多 CKD 筛查诊断策略的必要性，以及对早期发现 CKD 的影响进行初级保健教育的必要性，以预防不良结局并改善糖尿病管理。
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