Moosazadeh Mahmood, Gholami Farhad, Ebrahimnejad Pedram, Rafiei Alireza, Khazaee-Pool Maryam, Abastabar Mahdi, Mardanshah Fatemeh, Kheradmand Motahareh
Gastrointestinal Cancer Research Center, Non-Communicable Diseases Research Institute, Mazandaran University of Medical Sciences, Mazandaran, Iran.
Department of Internal Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran.
BMC Nephrol. 2025 Aug 21;26(1):479. doi: 10.1186/s12882-025-04383-x.
Chronic kidney disease (CKD) is a well-established public health concern worldwide. Considering the asymptomatic nature of early-stage CKD and its importance, we aimed to investigate the prevalence of undiagnosed stage 3 CKD in a large-scale, population-based cohort study.
In this cross-sectional study, data collected during the enrollment phase of the Tabari Cohort Study (TCS) were utilized. Between June 2015 and November 2017, 10,255 men and women aged 35-70 years were enrolled. CKD was determined based on the estimated glomerular filtration rate (eGFR). The Modification of Diet in Renal Disease (MDRD) equation, utilizing serum creatinine, was used to calculate eGFR. In the present study, participants with 30 ≤ GFR < 60 mL/min/1.73 m² were considered to have stage 3 CKD, and undiagnosed stage 3 CKD was defined as those unaware of CKD at enrollment but had an eGFR between 30 and 60 mL/min/1.73 m². Chi-square tests and univariate and multivariate logistic regression analyses were used to analyze the data.
Out of 10,255 TCS participants, 25.6% (N = 2,630) had stage 3 CKD (30 ≤ eGFR < 60 mL/min/1.73 m²), with 98.1% (N = 2,579) being unaware of their disease. Multivariate logistic regression results showed that the risk of undiagnosed stage 3 CKD was significantly lower in mountainous residents (OR: 0.30, 95% CI: 0.13-0.73, P = 0.008) and participants with hypertension (OR: 0.35, 95% CI: 0.18-0.66, P = 0.001), diabetes (OR: 0.52, 95% CI: 0.29-0.95, P = 0.032), and cardiovascular disease (OR: 0.44, 95% CI: 0.23-0.82, P = 0.010) compared to urban residents and those without hypertension, diabetes, and cardiovascular diseases, respectively.
The present study demonstrated a substantially high prevalence of undiagnosed stage 3 CKD. Urban residency and the absence of medical history of hypertension, diabetes, or cardiovascular disease were predictive factors of undiagnosed stage 3 CKD.
慢性肾脏病（CKD）是全球公认的公共卫生问题。鉴于早期CKD的无症状性质及其重要性，我们旨在通过一项大规模、基于人群的队列研究来调查未诊断的3期CKD的患病率。
在这项横断面研究中，使用了塔巴里队列研究（TCS）入组阶段收集的数据。2015年6月至2017年11月期间，纳入了10255名年龄在35 - 70岁之间的男性和女性。CKD根据估计肾小球滤过率（eGFR）来确定。采用肾脏病饮食改良（MDRD）方程，利用血清肌酐来计算eGFR。在本研究中，eGFR为30≤GFR＜60 mL/min/1.73m²的参与者被认为患有3期CKD，未诊断的3期CKD定义为那些在入组时未意识到自己患有CKD但eGFR在30至60 mL/min/1.73m²之间的人。采用卡方检验以及单因素和多因素逻辑回归分析来分析数据。
在10255名TCS参与者中，25.6%（N = 2630）患有3期CKD（30≤eGFR＜60 mL/min/1.73m²），其中98.1%（N = 2579）未意识到自己的病情。多因素逻辑回归结果显示，与城市居民以及分别没有高血压、糖尿病和心血管疾病的人相比，山区居民（比值比：0.30，95%置信区间：0.13 - 0.73；P = 0.008）、患有高血压的参与者（比值比：0.35，95%置信区间：0.18 - 0.66；P = 0.001）、糖尿病患者（比值比：0.52，95%置信区间：0.29 - 0.95；P = 0.032）和心血管疾病患者（比值比：0.44，95%置信区间：0.23 - 0.82；P = 0.010）未诊断的3期CKD风险显著较低。
本研究表明未诊断的3期CKD患病率相当高。城市居住以及没有高血压、糖尿病或心血管疾病病史是未诊断的3期CKD的预测因素。
