Wanner Christoph, Schaeffner Elke, Frese Thomas, Weber Christoph, Stahl Philipp, Scherg Felix, Burckhardt Fabian, Opfermann Ulrich, Radowsky Frank, Mader Frederik
Abteilung klinische Studien und Epidemiologie, Deutsches Zentrum für Herzinsuffizienz, Universitätsklinikum Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Deutschland.
Institut für Public Health, Charité Universitätsmedizin Berlin, Berlin, Deutschland.
MMW Fortschr Med. 2024 Apr;166(Suppl 4):9-17. doi: 10.1007/s15006-024-3684-y.
Despite the high prevalence of chronic kidney disease (CKD) in Germany, only a small proportion of patients are currently diagnosed with CKD. Patients with hypertension, diabetes mellitus, and/or cardiovascular disease have a significantly increased risk of developing CKD and rapid disease progression and should therefore be screened and monitored in accordance with the guidelines.
The aim of this retrospective, cross-sectional study was to gain insights into appropriate diagnosis of patients at risk for CKD in German general practitioner practices.
For the analysis of the use of CKD-relevant diagnostics, electronic patient records from German general practitioner practices were analyzed. Adults with hypertension and/or diabetes mellitus and/or cardiovascular disease with a documented observation period of at least one year were included in the study.
Data from a total of 448,837 patients from 1244 general practitioner practices were analyzed. 75.8% of patients had hypertension, 35.1% had cardiovascular disease, and 32.4% had diabetes mellitus. During a mean observation period of 1.7 years, serum creatinine was assessed at least once in 45.5% of patients. A urine dipstick test for albuminuria was performed in 7.9% of patients and in 0.4% of patients, urine albumin-to-creatine ratio (UACR) was measured. Laboratory diagnostics were initiated a little more frequently in high-risk patients compared to the overall cohort.
The study highlights that despite known risk factors, guideline compliant CKD screening is rarely performed in German general practitioner practices, which implicates the need to increase the awareness of early diagnosis of CKD in patients at risk.
尽管德国慢性肾脏病（CKD）的患病率很高，但目前只有一小部分患者被诊断为CKD。患有高血压、糖尿病和/或心血管疾病的患者发生CKD和疾病快速进展的风险显著增加，因此应根据指南进行筛查和监测。
这项回顾性横断面研究的目的是深入了解德国全科医生诊所中CKD高危患者的恰当诊断情况。
为了分析与CKD相关诊断方法的使用情况，对德国全科医生诊所的电子病历进行了分析。研究纳入了有高血压和/或糖尿病和/或心血管疾病且有至少一年记录观察期的成年人。
对来自1244家全科医生诊所的总共448,837名患者的数据进行了分析。75.8%的患者患有高血压，35.1%患有心血管疾病，32.4%患有糖尿病。在平均1.7年的观察期内，45.5%的患者至少接受过一次血清肌酐评估。7.9%的患者进行了尿蛋白试纸检测，0.4%的患者测量了尿白蛋白肌酐比值（UACR）。与总体队列相比，高危患者启动实验室诊断的频率略高。
该研究强调，尽管存在已知风险因素，但德国全科医生诊所很少按照指南进行CKD筛查，这意味着需要提高对CKD高危患者早期诊断的认识。
