Kotenko O N, Serdyukovskiy S M, Grishina N K, Ibragimov A I
City Clinical Hospital No. 52 of the Moscow Healthcare Department, 123182, Moscow, Russia.
N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia,
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Mar;29(2):327-330. doi: 10.32687/0869-866X-2021-29-2-327-330.
The chronic kidney disease takes a special place among chronic non-communicable diseases because it is characterized by wide prevalence worldwide. However, its detection rate among Moscow adult population is 1%, though in the European countries this indicator is significantly higher and is made up on average to 6%. At the terminal stage of chronic kidney disease, quality of life of such patients decreases dramatically, that result in working capacity loss and disability. These patients often require expensive methods of programmed hemo- and peritoneal dialysis. The corresponding mortality is much higher as compared with total mortality. Among the frequent causes of hospitalization and mortality of such patients, complications of blood circulation system diseases are registered. The existing problem of low detection of kidney pathology in the population is the main cause of untimely treatment start. The rapid disease progression results in higher indices of premature mortality and increased costs of treatment of patients with this pathology. The timely diagnosis of disorders of carbohydrate and lipid metabolism permits to identify chronic kidney disease at an early stage and to start to carry out adequate treatment and prevention measures. The purpose of the study is to implement the technology of improving efficiency of detection of chronic kidney disease. Methods. The organizational experiment, analytical, mathematical and statistical research methods. Results of the study. The detection rate of chronic kidney disease amounted to 8%. Among the respondents with chronic kidney disease diagnosed, more than 80% had initial stages of disease (I-III). In this case, appropriate therapy and prevention can prolong kidney functioning and reduce velocity of disease progression. At the same time, 16.3% of patients at the late stage of diseases progression (stages IV-V) were identified.The detection rate for all stages of chronic kidney disease increases with age Conclusions. The level of detection of chronic kidney disease in the base territory is comparable with the indices established in the European countries. The need to improve quality of diagnostic and prevention of chronic kidney disease was proven. To improve overall prognosis and prevention of development of terminal renal failure is possible only in case of brigade approach to treatment including active interaction of cardiologist and nephrologist, endocrinologist and nephrologist or of all these three specialists. Scope of the results. The established higher detection rate of chronic kidney disease (8%), as compared to actual one (1%), permits to claim that with systematic improvement of diagnosis, the detection of chronic kidney disease will increase iteratively and population need for nephrologic medical care will significantly increase that will require increasing in resource support and revising of planned and normative indices for this type of medical care.
慢性肾脏病在慢性非传染性疾病中占有特殊地位，因为它在全球范围内广泛流行。然而，莫斯科成年人口中的检出率为1%，而在欧洲国家，这一指标明显更高，平均达到6%。在慢性肾脏病终末期，这类患者的生活质量急剧下降，导致工作能力丧失和残疾。这些患者常常需要昂贵的计划性血液透析和腹膜透析方法。与总死亡率相比，相应的死亡率要高得多。在这类患者住院和死亡的常见原因中，登记有血液循环系统疾病的并发症。人群中肾脏病理检出率低这一现存问题是治疗开始不及时的主要原因。疾病的快速进展导致过早死亡率更高，以及这类患者的治疗费用增加。及时诊断碳水化合物和脂质代谢紊乱有助于在早期识别慢性肾脏病，并开始实施适当的治疗和预防措施。本研究的目的是实施提高慢性肾脏病检出效率的技术。方法。采用组织实验、分析、数学和统计研究方法。研究结果。慢性肾脏病的检出率达8%。在被诊断为慢性肾脏病的受访者中，超过80%处于疾病初期（I - III期）。在这种情况下，适当的治疗和预防可以延长肾脏功能并降低疾病进展速度。同时，确定了16.3%处于疾病进展后期（IV - V期）的患者。慢性肾脏病各阶段的检出率随年龄增长而增加。结论。基层地区慢性肾脏病的检出水平与欧洲国家确定的指标相当。已证明有必要提高慢性肾脏病诊断和预防的质量。只有采取团队治疗方法，包括心脏病专家与肾病专家、内分泌专家与肾病专家或这三位专家共同积极互动，才有可能改善总体预后并预防终末期肾衰竭的发生。结果范围。与实际检出率（1%）相比，确定的慢性肾脏病较高检出率（8%）表明，随着诊断的系统性改善，慢性肾脏病的检出将迭代增加，人群对肾病医疗护理的需求将显著增加，这将需要增加资源支持并修订这类医疗护理的计划和规范指标。
