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慢性肾脏病在伴有动脉高血压和/或糖尿病的巴西人群中的流行情况。

Prevalence of chronic kidney disease in Brazilians with arterial hypertension and/or diabetes mellitus.

机构信息

Department of Nutrition and Health, Federal University of Viçosa, Graduate Program in Nutrition and Health, Viçosa, MG, Brazil.

Nutrition Course, School of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil.

出版信息

J Clin Hypertens (Greenwich). 2020 Sep;22(9):1666-1673. doi: 10.1111/jch.13980. Epub 2020 Aug 9.

Abstract

The present study aimed to evaluate the prevalence of chronic kidney disease (CKD) in individuals with arterial hypertension (AH) and/or diabetes mellitus (DM) accompanied by Primary Health Care (PHC) in Brazil. The estimated glomerular filtration rate (eGFR) based on creatinine, and urinary albumin-to-creatinine ratio (ACR) were measured in 841 subjects with AH and/or DM, followed by PHC in the city of Viçosa. The CKD was diagnosed according to KDIGO criteria. Sociodemographic, clinical, and anthropometric factors related to the prevalence of CKD were investigated through multiple logistic regression. The prevalence of hidden CKD was 15.4%. Of these, 7.5% were identified by albuminuria (ACR ≥30 mg/g) with slightly decreased eGFR. Age, baseline disease, waist circumference (WC), and systolic blood pressure remained associated with CKD after multivariate analysis. The two major risk factors for hidden CKD were the presence of AH in association with DM and an increase in age. Hidden CKD was more common within people with AH and DM, and with high WC, glycosylated hemoglobin, and serum phosphorus as well as male gender and decreased serum albumin. This knowledge of risk associations can help avoid progression to CKD.

摘要

本研究旨在评估巴西伴有初级卫生保健(PHC)的动脉高血压(AH)和/或糖尿病(DM)患者中慢性肾脏病(CKD)的患病率。在维索萨市,对 841 名患有 AH 和/或 DM 的患者进行了基于肌酐的估计肾小球滤过率(eGFR)和尿白蛋白与肌酐比值(ACR)的测量,并进行了 PHC。根据 KDIGO 标准诊断 CKD。通过多因素逻辑回归调查了与 CKD 患病率相关的社会人口学、临床和人体测量学因素。隐匿性 CKD 的患病率为 15.4%。其中,7.5% 通过白蛋白尿(ACR≥30mg/g)和轻度降低的 eGFR 确定。在多变量分析后,年龄、基线疾病、腰围(WC)和收缩压与 CKD 仍然相关。隐匿性 CKD 的两个主要危险因素是 AH 与 DM 并存以及年龄增长。AH 和 DM 患者、WC 高、糖化血红蛋白和血清磷高以及男性和血清白蛋白降低的患者中,隐匿性 CKD 更为常见。了解这些风险关联有助于避免 CKD 的进展。

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