The George Institute for Global Health, Newtown, New South Wales, Australia.
School of Medicine, University of Sydney, Sydney, NSW, Australia.
BMJ Glob Health. 2022 Jan;7(1). doi: 10.1136/bmjgh-2021-007525.
The burden of chronic kidney disease (CKD) is growing rapidly around the world. However, there is limited information on the overall regional prevalence of CKD, as well as the variations in national prevalence within Asia. We aimed to consolidate available data and quantify estimates of the CKD burden in this region.
We systematically searched MEDLINE, Embase and Google Scholar for observational studies and contacted national experts to estimate CKD prevalence in countries of Asia (Eastern, Southern and South Eastern Asia). CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m or the presence of proteinuria. For countries without reported data, we estimated CKD prevalence using agglomerative average-linkage hierarchical clustering, based on country-level risk factors and random effects meta-analysis within clusters. Published CKD prevalence data were obtained for 16 countries (of the 26 countries in the region) and estimates were made for 10 countries.
There was substantial variation in overall and advanced (eGFR <30 mL/min/1.73 m) CKD prevalence (range: 7.0%-34.3% and 0.1%-17.0%, respectively). Up to an estimated 434.3 million (95% CI 350.2 to 519.7) adults have CKD in Asia, including up to 65.6 million (95% CI 42.2 to 94.9) who have advanced CKD. The greatest number of adults living with CKD were in China (up to 159.8 million, 95% CI 146.6 to 174.1) and India (up to 140.2 million, 95% CI 110.7 to 169.7), collectively having 69.1% of the total number of adults with CKD in the region.
The large number of people with CKD, and the substantial number with advanced CKD, show the need for urgent collaborative action in Asia to prevent and manage CKD and its complications.
慢性肾脏病（CKD）的负担在全球范围内迅速增加。然而，关于亚洲地区 CKD 的总体区域性患病率以及各国患病率的变化，相关信息有限。我们旨在整合现有数据并量化该地区 CKD 负担的估计值。
我们系统地检索了 MEDLINE、Embase 和 Google Scholar 中的观察性研究，并联系了各国专家以估算亚洲国家（东亚、南亚和东南亚）的 CKD 患病率。CKD 的定义为估计肾小球滤过率（eGFR）<60ml/min/1.73m 或蛋白尿。对于没有报告数据的国家，我们根据国家层面的风险因素，并使用聚类内的随机效应荟萃分析，基于聚集平均链接层次聚类法估计 CKD 患病率。获得了该地区 26 个国家中的 16 个国家的 CKD 患病率数据，并对其中 10 个国家进行了估计。
总体 CKD 和晚期 CKD（eGFR<30ml/min/1.73m）的患病率存在很大差异（范围分别为 7.0%-34.3%和 0.1%-17.0%）。亚洲地区估计有 4.343 亿成年人患有 CKD（95%CI 3502 万至 5197 万），其中多达 6560 万人（95%CI 4220 万至 9490 万）患有晚期 CKD。患有 CKD 的成年人数量最多的是中国（多达 1.598 亿人，95%CI 1.466 亿至 1.741 亿）和印度（多达 1.402 亿人，95%CI 1.107 亿至 1.697 亿），合计占该地区 CKD 患者总数的 69.1%。
大量患有 CKD 的患者，以及大量患有晚期 CKD 的患者，表明亚洲地区迫切需要采取协作行动来预防和管理 CKD 及其并发症。
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