Clinic Specialized in the Diabetes Management in Mexico City, IMSS-Bienestar Public Health Services, Ciudad de México, México.
Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241259325. doi: 10.1177/21501319241259325.
To assess the prevalence and risk factors for chronic kidney disease (CKD) among adults with type 2 diabetes within primary care.
This cross-sectional study evaluated 1319 individuals receiving standard care across 26 primary units from July 2017 to January 2023. The estimated glomerular filtration rate (eGFR) and albuminuria were used for the diagnosis of CKD. CKD was defined by eGFR values of <60 mL/min/1.73 m and/or albumin-to-creatine ratio ≥30 mg/g. Logistic regression was applied to identify factors associated with CKD and study variables.
The median age of participants (60.6% females) was 55 years and the median diabetes duration was 10 years. The overall CKD prevalence in the study population was 39.2%. Within the CKD group, the prevalence rates of albuminuria, albuminuria coupled with low eGFR and isolated low eGFR were 72.1%, 19%, and 8.9%, respectively. The prevalence of CKD was 30.6% among participants under 40 years old and a higher value was observed in middle-aged adults with early-onset diabetes (at age <40 years) compared with the later-onset group. Multivariable analyses identified associations between CKD and factors such as age, the male sex, diabetes duration, hypertension, retinopathy, and metformin use.
A relatively high prevalence of CKD, especially in non-elderly adults, was revealed in this primary care study. Early recognition strategies for CKD are crucial for timely prevention within primary care.
评估初级保健中 2 型糖尿病成人慢性肾脏病（CKD）的患病率和危险因素。
本横断面研究评估了 2017 年 7 月至 2023 年 1 月期间来自 26 个初级单位的 1319 名接受标准治疗的个体。估算肾小球滤过率（eGFR）和蛋白尿用于 CKD 的诊断。CKD 的定义为 eGFR 值<60 mL/min/1.73 m2 和/或白蛋白与肌酐比值≥30 mg/g。应用逻辑回归分析确定与 CKD 相关的因素和研究变量。
参与者的中位年龄（60.6%为女性）为 55 岁，中位糖尿病病程为 10 年。研究人群的总体 CKD 患病率为 39.2%。在 CKD 组中，蛋白尿、蛋白尿合并低 eGFR 和单纯低 eGFR 的患病率分别为 72.1%、19%和 8.9%。在 40 岁以下的参与者中，CKD 的患病率为 30.6%，而在中年起病（<40 岁）的早期发病患者中，该值高于迟发组。多变量分析确定了 CKD 与年龄、男性、糖尿病病程、高血压、视网膜病变和二甲双胍使用等因素之间的关联。
在这项初级保健研究中，揭示了 CKD 的相对较高患病率，尤其是在非老年成年人中。早期识别 CKD 的策略对于初级保健中的及时预防至关重要。
