Samaan Farid, Damiani Bruna Bronhara, Kirsztajn Gianna Mastroianni, Sesso Ricardo
Research Division, Dante Pazzanese Cardiology Institute, São Paulo 04012-909, SP, Brazil.
Nephrology Division, Universidade Federal de São Paulo, São Paulo 04023-900, SP, Brazil.
Diagnostics (Basel). 2023 Mar 16;13(6):1146. doi: 10.3390/diagnostics13061146.
Chronic kidney disease (CKD) provides a worse prognosis for patients with heart disease. In Latin America, studies that analyzed the prevalence and risk stratification of CKD in this population are scarce. We aimed to evaluate CKD prevalence and risk categories in patients of a public referral cardiology hospital in São Paulo, Brazil. This was a cross-sectional study based on a laboratory database. Outpatient serum creatinine and proteinuria results performed between 1 January 2021 and 31 December 2021 were analyzed. CKD was defined by estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m and proteinuria, by the albumin/creatinine ratio in a spot urine sample (UACR) >30 mg/g. A total of 36,651 adults were identified with serum creatinine levels (median age 72.4 [IQR, 51.0-73.6] years, 51% male). Among them, 51.9% had UACR dosage (71.5% with UACR < 30 mg/g, 22.6%, between 30-300 mg/g, and 5.9% with UACR > 300 mg/g). The prevalence of CKD was 30.9% (15.3% stage 3a, 10.2% stage 3b, 3.6% stage 4, and 1.7% stage 5), and the distribution of patients in the risk categories of the disease was: 52.0% with low-risk, 23.5%, moderate risk, 13.0%, high risk, and 11.2%, very high. In an outpatient setting, the prevalence of CKD in cardiological patients was almost three times (31%) that of the general population; about half of the individuals evaluated (48%) were not screened for an important risk marker (proteinuria), and approximately a quarter of these patients (24%) were in the high or very high CKD risk categories.
慢性肾脏病（CKD）会使心脏病患者的预后更差。在拉丁美洲，分析该人群中CKD患病率和风险分层的研究很少。我们旨在评估巴西圣保罗一家公立转诊心脏病医院患者的CKD患病率和风险类别。这是一项基于实验室数据库的横断面研究。分析了2021年1月1日至2021年12月31日期间门诊患者的血清肌酐和蛋白尿结果。CKD的定义为估计肾小球滤过率（eGFR）<60 mL/min/1.73 m²且有蛋白尿，即随机尿样中白蛋白/肌酐比值（UACR）>30 mg/g。共确定了36,651名成年人有血清肌酐水平（中位年龄72.4[四分位间距，51.0 - 73.6]岁，51%为男性）。其中，51.9%进行了UACR检测（71.5%的UACR<30 mg/g，22.6%在30 - 300 mg/g之间，5.9%的UACR>300 mg/g）。CKD的患病率为30.9%（3a期为15.3%，3b期为10.2%，4期为3.6%，5期为1.7%），疾病风险类别的患者分布为：低风险52.0%，中度风险23.5%，高风险13.0%，极高风险11.2%。在门诊环境中，心脏病患者中CKD的患病率几乎是普通人群的三倍（31%）；约一半接受评估的个体（48%）未筛查重要风险标志物（蛋白尿），这些患者中约四分之一（24%）处于CKD高风险或极高风险类别。
