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社区居住的中国老年人群中肾功能降低的流行状况及其与健康状况的关系:中国健康与养老追踪调查。

Prevalence and health correlates of reduced kidney function among community-dwelling Chinese older adults: the China Health and Retirement Longitudinal Study.

机构信息

Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.

Kidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, Zhejiang, China.

出版信息

BMJ Open. 2020 Dec 10;10(12):e042396. doi: 10.1136/bmjopen-2020-042396.

Abstract

OBJECTIVES

We aimed to understand the prevalence of reduced kidney function in China by sociodemographics and geographical region, and to examine health correlates of reduced kidney function.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

Participants were 6706 adults ≥60 years from the 2015-2016 wave of the China Health and Retirement Longitudinal Study.

OUTCOME MEASURES

Reduced kidney function was defined as an estimated glomerular filtration rate of less than 60 mL/min per 1.73 m². The estimated glomerular filtration rate was calculated with the creatinine-cystatin C equation developed by the Chronic Kidney Disease Epidemiology Collaboration in 2012. The associations between reduced kidney function and potential risk factors were analysed using multivariable regression models.

RESULTS

The prevalence of reduced kidney function was 10.3% (95% CI: 9.3% to 11.2%), corresponding to approximately 20 million older adults. Multivariable analysis showed that older adults with hypertension (β=-3.61, 95% CI: -4.42 to 2.79), cardiac disease (β=-1.90, 95% CI: -2.93 to 0.86), who had a stroke (β=-3.75, 95% CI: -6.35 to 1.15), kidney disease (β=-3.88, 95% CI: -5.62 to 2.13), slow gait speed (β=-2.23, 95% CI: -3.27 to 1.20), and living in the South (β=-4.38, 95% CI: -5.95 to 2.80) and South Central (β=-1.85, 95% CI: -3.15 to 0.56) were more significantly likely to have reduced kidney function.

CONCLUSIONS

Kidney function screening should be performed, especially in patients with hypertension, cardiac disease and who had a stroke. More efforts should be paid to improve the kidney function of older adults living in the South and South Central parts of China.

摘要

目的

通过社会人口统计学和地理区域了解中国肾功能减退的流行情况,并探讨肾功能减退的健康相关因素。

设计

横断面研究。

设置和参与者

参与者为来自 2015-2016 年中国健康与退休纵向研究的 6706 名≥60 岁的成年人。

结果测量

肾功能减退定义为估计肾小球滤过率(eGFR)<60mL/min/1.73m²。eGFR 使用 2012 年慢性肾脏病流行病学合作研究开发的肌酐-胱抑素 C 方程进行计算。使用多变量回归模型分析肾功能减退与潜在风险因素之间的关系。

结果

肾功能减退的患病率为 10.3%(95%可信区间:9.3%至 11.2%),相当于约 2000 万老年人。多变量分析显示,患有高血压(β=-3.61,95%置信区间:-4.42 至 2.79)、心脏病(β=-1.90,95%置信区间:-2.93 至 0.86)、中风(β=-3.75,95%置信区间:-6.35 至 1.15)、肾脏疾病(β=-3.88,95%置信区间:-5.62 至 2.13)、步态缓慢(β=-2.23,95%置信区间:-3.27 至 1.20)和居住在南方(β=-4.38,95%置信区间:-5.95 至 2.80)和中南地区(β=-1.85,95%置信区间:-3.15 至 0.56)的老年人更有可能出现肾功能减退。

结论

应进行肾功能筛查,特别是在患有高血压、心脏病和中风的患者中。应更加努力改善中国南方和中南地区老年人的肾功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f66e/7733173/abe8fd056ff1/bmjopen-2020-042396f01.jpg

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