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影响慢性肾脏病发病率的因素:来自韩国国民健康保险共享服务(NHISS)的数据库。

The Factors Influencing Chronic Kidney Disease Incidence: Database from the Korean National Health Insurance Sharing Service (NHISS).

作者信息

Ko Ho-Joon, Ahn Soon-Ki, Han Suyeon, Kim Moo-Jun, Na Ki Ryang, Park Hyerim, Choi Dae Eun

机构信息

Department of Nephrology, Chungnam National University Hospital, Daejeon 35015, Republic of Korea.

Department of Preventive Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea.

出版信息

J Clin Med. 2024 Apr 9;13(8):2164. doi: 10.3390/jcm13082164.

Abstract

The global prevalence of chronic kidney disease (CKD) is increasing, with diabetes accounting for the highest proportion. We analyzed the influence of clinical factors on the incidence of CKD according to the renal function, primary focusing on patients with diabetes. We used the Sample Cohorts Database provided by the National Health Insurance Sharing Service (NHISS) in Korea. Participants aged ≥ 40 years who underwent a health checkup in 2009 were categorized into six groups based on their eGFR values (<60 mL/min, 60-89 mL/min, ≥90 mL/min) and the presence of diabetes. And all patients with CKD at 2009 screening were excluded. The participants were tracked from 2010 to 31 December 2019. The CKD incidence rate according to the eGFR values and the effect of the accompanying factors on CKD incidence were confirmed. 148,089 people without CKD were analyzed. The CKD incidence rate was highest in those with eGFR < 60 mL/min with diabetes and lowest in those with eGFR ≥ 90 mL/min without diabetes. The CKD incidence rates were similar between the eGFR < 60 mL/min group without diabetes and the eGFR 60-89 mL/min group with diabetes. Compared to under 44 years of age, the hazard ratio of CKD incidence was 8 times higher in over 75 years of age. Men had a 1.7-fold higher risk of developing CKD than women. Current smoker, hypertension, dyslipidemia, myocardial infarction history, and atrial fibrillation and flutter increased the risk of CKD incidence. Age, diabetes, and baseline eGFR are important factors in the occurrence of CKD. As age increases, the risk of developing CKD in men increases compared to women. These results will be helpful in predicting risk groups for CKD and establishing strategies to lowering CKD incidence.

摘要

慢性肾脏病(CKD)的全球患病率正在上升,其中糖尿病患者占比最高。我们根据肾功能分析了临床因素对CKD发病率的影响,主要聚焦于糖尿病患者。我们使用了韩国国民健康保险共享服务(NHISS)提供的样本队列数据库。2009年接受健康检查的年龄≥40岁的参与者根据其估算肾小球滤过率(eGFR)值(<60 mL/分钟、60 - 89 mL/分钟、≥90 mL/分钟)和是否患有糖尿病被分为六组。并且排除了2009年筛查时所有患有CKD的患者。对这些参与者从2010年追踪至2019年12月31日。确认了根据eGFR值的CKD发病率以及伴随因素对CKD发病率的影响。分析了148,089名无CKD的人。CKD发病率在eGFR < 60 mL/分钟且患有糖尿病的人群中最高,在eGFR≥90 mL/分钟且无糖尿病的人群中最低。eGFR < 60 mL/分钟且无糖尿病的组与eGFR 60 - 89 mL/分钟且患有糖尿病的组之间的CKD发病率相似。与44岁以下人群相比,75岁以上人群CKD发病的风险比高8倍。男性患CKD的风险比女性高1.7倍。当前吸烟者、高血压、血脂异常、心肌梗死病史以及心房颤动和扑动会增加CKD发病风险。年龄、糖尿病和基线eGFR是CKD发生的重要因素。随着年龄增长,男性患CKD的风险相对于女性增加。这些结果将有助于预测CKD的风险群体并制定降低CKD发病率的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bd0/11050717/e881dec1deaf/jcm-13-02164-g001.jpg

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