Santos-Araújo Carla, Mendonça Luís, Carvalho Daniel Seabra, Bernardo Filipa, Pardal Marisa, Couceiro João, Martinho Hugo, Gavina Cristina, Taveira-Gomes Tiago, Dinis-Oliveira Ricardo Jorge
UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.
Nephrology Department, Pedro Hispano Hospital, Senhora da Hora, Matosinhos, Portugal.
Clin Kidney J. 2022 Sep 12;16(1):111-124. doi: 10.1093/ckj/sfac206. eCollection 2023 Jan.
Chronic kidney disease (CKD) represents a global public health burden, but its true prevalence is not fully characterized in the majority of countries. We studied the CKD prevalence in adult users of the primary, secondary and tertiary healthcare units of an integrated health region in northern Portugal ( = 136 993; representing ∼90% of the region's adult population). Of these, 45 983 (33.6%) had at least two estimated glomerular filtration rate (eGFR) assessments and 30 534 (22.2%) had at least two urinary albumin:creatinine ratio (UACR) assessments separated by at least 3 months. CKD was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines as a persistent decrease in eGFR (<60 ml/min/1.73 m) and/or an increase in UACR (≥30 mg/g). The estimated overall prevalence of CKD was 9.8% and was higher in females (5.5%) than males (4.2%). From these, it was possible to stratify 4.7% according to KDIGO guidelines. The prevalence of CKD was higher in older patients (especially in patients >70 years old) and in patients with comorbidities. This is the first real-world-based study to characterize CKD prevalence in a large, unselected Portuguese population. It probably provides the nearest estimate of the true CKD prevalence and may help healthcare providers to guide CKD-related policies and strategies focused on prevention and on the improvement of cardiovascular disease and other outcomes.
慢性肾脏病（CKD）是一项全球性的公共卫生负担，但在大多数国家，其真实患病率尚未得到充分描述。我们研究了葡萄牙北部一个综合健康区域的初级、二级和三级医疗保健机构成年使用者中的CKD患病率（n = 136993；约占该地区成年人口的90%）。其中，45983人（33.6%）至少进行了两次估算肾小球滤过率（eGFR）评估，30534人（22.2%）至少进行了两次尿白蛋白与肌酐比值（UACR）评估，且两次评估间隔至少3个月。根据改善全球肾脏病预后（KDIGO）指南，CKD的定义为eGFR持续下降（<60 ml/min/1.73 m²）和/或UACR升高（≥30 mg/g）。CKD的总体估计患病率为9.8%，女性（5.5%）高于男性（4.2%）。据此，根据KDIGO指南可将4.7%的患者进行分层。老年患者（尤其是70岁以上患者）和合并症患者的CKD患病率更高。这是第一项基于现实世界对葡萄牙大量未经过筛选的人群进行CKD患病率特征描述的研究。它可能提供了最接近真实CKD患病率的估计值，并可能有助于医疗保健提供者制定以预防以及改善心血管疾病和其他预后为重点的CKD相关政策和策略。
