Nguyen Kevin H, Thorsness Rebecca, Swaminathan Shailender, Mehrotra Rajnish, Patzer Rachel E, Lee Yoojin, Kim Daeho, Rivera-Hernandez Maricruz, Trivedi Amal N
Kevin H. Nguyen (
Rebecca Thorsness is a research associate in the Department of Health Services, Policy, and Practice, Brown University School of Public Health, and a fellow in the Veterans Affairs New England Healthcare System, in Bedford, Massachusetts.
Health Aff (Millwood). 2021 Dec;40(12):1900-1908. doi: 10.1377/hlthaff.2021.00458.
National estimates suggest that kidney failure incidence is declining in the US. However, whether this trend is evident in areas with socioeconomic disadvantage is unknown. We examined trends in kidney failure incidence by county-level poverty between 2000 and 2017 and divided the study period into period 1 (2000-05), period 2 (2006-11), and period 3 (2012-17). The magnitude of disparity in kidney failure incidence between high- and low-poverty counties increased from 42.8 more incident cases per million in high-poverty counties in period 1 to 100.1 more in period 3. Despite a national decline, kidney failure incidence increased in high-poverty counties, and disparities between high- and low-poverty counties widened from 2000 to 2017. Achieving the Department of Health and Human Services objective of reducing incident kidney failure cases by 25 percent by 2030 will require focused attention on preventing kidney failure in counties with higher poverty.
全国性评估表明，美国肾衰竭发病率正在下降。然而，在社会经济条件不利的地区，这一趋势是否明显尚不清楚。我们研究了2000年至2017年间按县级贫困程度划分的肾衰竭发病率趋势，并将研究期分为第1阶段（2000 - 2005年）、第2阶段（2006 - 2011年）和第3阶段（2012 - 2017年）。高贫困县和低贫困县之间肾衰竭发病率的差距幅度从第1阶段高贫困县每百万人口中多42.8例发病病例增加到第3阶段的多100.1例。尽管全国范围内发病率有所下降，但高贫困县的肾衰竭发病率却有所上升，并且从2000年到2017年，高贫困县和低贫困县之间的差距进一步扩大。要实现美国卫生与公众服务部在2030年前将新发肾衰竭病例减少25%的目标，需要重点关注贫困程度较高的县预防肾衰竭的工作。
