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洛兰-法尔斯特健康研究中未被识别的慢性肾脏病的高患病率:丹麦一个农村省级地区的一项基于人群的研究。

High prevalence of unrecognized chronic kidney disease in the Lolland-Falster Health Study: a population-based study in a rural provincial area of Denmark.

作者信息

Mannheimer Ebba, Buus Jørgensen Morten, Hommel Kristine, Kamper Anne-Lise, Jepsen Randi, Rasmussen Knud, Thygesen Lau Caspar, Feldt-Rasmussen Bo, Hornum Mads

机构信息

Department of Nephrology and Endocrinology, Rigshospitalet, Copenhagen, Denmark.

Department of Medicine, Holbæk Hospital, Holbæk, Denmark.

出版信息

Eur J Public Health. 2025 Jun 1;35(3):449-455. doi: 10.1093/eurpub/ckae208.

Abstract

Chronic kidney disease (CKD) affects 10-15% globally and is a marked independent risk factor for cardiovascular disease. Prevalence estimations are essential for public health planning and implementation of CKD treatment strategies. This study aimed to estimate the prevalence and stages of CKD in the population-based Lolland-Falster Health Study, set in a rural provincial area with the lowest socioeconomic status in Denmark. Additionally, the study characterized participants with CKD, evaluated the overall disease recognition, including the awareness of CKD and compared it with other common conditions. Cross-sectional data were obtained from clinical examinations, biochemical analyses, and questionnaires. CKD was defined as albuminuria (urine albumin-creatinine ratio ≥30 mg/g), estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m², or by a diagnosis in the National Patient Register. Patient awareness was assessed by self-reported CKD, and overall disease recognition by either a registered hospital diagnosis or self-reported CKD. Among 16 097 adults (median age 58.6 years), CKD prevalence was 18.0% (n = 2903), with 70.1% identified by albuminuria, 28.4% by reduced eGFR, and 1.5% by a registered diagnosis alone. Of those with CKD, 98.8% had stages 1-3 (eGFR ≥30 ml/min/1.73 m²), and 1.2% had stages 4-5 (eGFR <30 ml/min/1.73 m²). Female sex, comorbidities, smoking, and low socioeconomic parameters were independently associated with CKD. Patient awareness of CKD was 4.4%, compared to >50% for hypertension and >80% for diabetes, and the overall CKD recognition (self-reported or registered diagnosis) was 7.1%. Thus, in this population-based study, CKD was highly prevalent but poorly recognized, indicating great potential for preventing CKD progression and related complications.

摘要

慢性肾脏病(CKD)在全球的影响范围为10%-15%,是心血管疾病显著的独立危险因素。患病率估计对于公共卫生规划和CKD治疗策略的实施至关重要。本研究旨在估计丹麦社会经济地位最低的农村省级地区基于人群的洛兰-法尔斯特健康研究中CKD的患病率和分期。此外,该研究对CKD患者进行了特征描述,评估了整体疾病认知情况,包括对CKD的知晓情况,并将其与其他常见疾病进行了比较。通过临床检查、生化分析和问卷调查获取横断面数据。CKD的定义为蛋白尿(尿白蛋白-肌酐比值≥30mg/g)、估计肾小球滤过率(eGFR)<60ml/min/1.73m²,或依据国家患者登记处的诊断。通过自我报告的CKD评估患者知晓情况,通过登记的医院诊断或自我报告的CKD评估整体疾病认知情况。在16097名成年人(中位年龄58.6岁)中,CKD患病率为18.0%(n=2903),其中70.1%通过蛋白尿确诊,28.4%通过eGFR降低确诊,1.5%仅通过登记诊断确诊。在患有CKD的患者中,98.8%处于1-3期(eGFR≥30ml/min/1.73m²),1.2%处于4-5期(eGFR<30ml/min/1.73m²)。女性、合并症、吸烟和低社会经济参数与CKD独立相关。CKD患者的知晓率为4.4%,而高血压的知晓率>50%,糖尿病的知晓率>80%,CKD的整体认知率(自我报告或登记诊断)为7.1%。因此,在这项基于人群的研究中,CKD患病率很高但认知度很低,这表明在预防CKD进展及相关并发症方面具有巨大潜力。

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