National Center for Chronic and Noncommunicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
National Clinical Research Center for Kidney Disease, Nanfang Hospital, Guangzhou, China.
JAMA Intern Med. 2023 Apr 1;183(4):298-310. doi: 10.1001/jamainternmed.2022.6817.
To our knowledge, there has been no update on the prevalence of chronic kidney disease (CKD) in China since 2012.
To provide periodic nationwide data on the prevalence of CKD and the associated behavioral and metabolic risk factors in China.
DESIGN, SETTING, AND PARTICIPANTS: This nationally representative cross-sectional study included data from 176 874 adults from all 31 provincial-level administrative divisions in mainland China, as reported in the sixth China Chronic Disease and Risk Factor Surveillance conducted from August 2018 to June 2019. Data analysis was performed in 2021 to 2022.
Serum creatinine, urinal creatinine, and urine albumin were measured for all participants. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine using the CKD-EPI equation.
The primary outcome was weighted prevalence of CKD in the overall population and different strata, defined as presence of impaired kidney function (eGFR of <60 mL/min/1.73m2) or albuminuria (urine albumin-to-creatinine ratio of ≥30 mg/g). Secondary outcomes were awareness of CKD and control of comorbidities. Logistic regression was used to examine the association of sociodemographic characteristics, behavioral and dietary habits, physical activity, and comorbidities with CKD.
A total of 184 876 participants contributed data to this study, and of the 176 874 adults 18 years and older with measurements of eGFR and urine albumin-to-creatinine ratio in 2018 to 2019, the mean age was 43.8 years and the weighted proportion of women was 44.6%. The estimated prevalence of CKD, impaired kidney function, and albuminuria were 8.2%, 2.2%, and 6.7%, respectively. A higher prevalence of CKD was observed in the subgroups characterized by older age, female gender, non-Han ethnicity, residency of rural or north and central parts of China, receiving less education or lower income, former smoking, no alcohol drinking, lacking physical activity, and presence of risk factors such as obesity, hypertension, diabetes, dyslipidemia, and self-reported cardiovascular disease. Among the adults with CKD, 73.3%, 25.0%, and 1.8% were at stage 1 to 2, 3, and 4 to 5, respectively, and the awareness of CKD was 10.0%.
This cross-sectional study found a weighted estimated of 82 million adults with CKD in China in 2018 to 2019. The prevalence appears to have decreased by 30% in the past decade. Better environmental protection, integration of CKD into the national public health surveillance program, and control of common CKD comorbidities appear to be associated with reducing the disease burden of CKD.
据我们所知，自 2012 年以来，中国慢性肾脏病（CKD）的患病率尚无最新数据。
提供中国 CKD 患病率及相关行为和代谢风险因素的定期全国性数据。
设计、地点和参与者：本研究为全国代表性的横断面研究，数据来自于 2018 年 8 月至 2019 年 6 月期间中国大陆 31 个省级行政区的 176874 名成年人，报告来自第六次中国慢性病及其危险因素监测。数据分析于 2021 年至 2022 年进行。
所有参与者均进行血清肌酐、尿肌酐和尿白蛋白检测。肾小球滤过率（eGFR）使用 CKD-EPI 方程根据血清肌酐进行计算。
主要结局为总体人群及不同分层的 CKD 加权患病率，定义为存在肾功能受损（eGFR<60 mL/min/1.73m2）或蛋白尿（尿白蛋白与肌酐比值≥30 mg/g）。次要结局为 CKD 的知晓率和合并症的控制情况。采用 logistic 回归分析社会人口学特征、行为和饮食习惯、体力活动以及合并症与 CKD 的关系。
共有 184876 名参与者提供了数据，在 2018 年至 2019 年接受 eGFR 和尿白蛋白与肌酐比值检测的 176874 名 18 岁及以上成年人中，平均年龄为 43.8 岁，女性比例加权为 44.6%。CKD、肾功能受损和蛋白尿的估计患病率分别为 8.2%、2.2%和 6.7%。年龄较大、女性、非汉族、居住在农村或中国北方和中部、受教育程度较低或收入较低、曾经吸烟、不饮酒、缺乏体力活动以及存在肥胖、高血压、糖尿病、血脂异常和心血管疾病等风险因素的亚组中，CKD 的患病率较高。在患有 CKD 的成年人中，分别有 73.3%、25.0%和 1.8%处于 1 至 2 期、3 期和 4 至 5 期，CKD 的知晓率为 10.0%。
本横断面研究发现，2018 年至 2019 年中国约有 8200 万成年人患有 CKD。在过去十年中，患病率似乎下降了 30%。更好的环境保护、将 CKD 纳入国家公共卫生监测计划以及控制常见的 CKD 合并症似乎与降低 CKD 的疾病负担有关。
