Young E W
Nephrology Section, VA Medical Center, Ann Arbor, MI 48105, USA.
Semin Nephrol. 1997 May;17(3):170-5.
An understanding of the causes of end-stage renal disease (ESRD) is approached through a discussion of currently attributed causes, potentially unattributed causes, and the reasons for growth in new ESRD cases. The attributed causes of ESRD have varied over time and by region. In the United States, diabetes has long been the most common attributed cause of ESRD, accounting for 36% of incident cases in 1992. In contrast, diabetic ESRD is far less common in other countries. Hypertension and glomerulonephritis are the next most commonly attributed causes of ESRD, but these diagnoses are not necessarily based on consistent or uniform criteria. Mistaken classification of the cause of ESRD is possible in many cases. Emerging evidence suggests that other processes, including renovascular disease and analgesic ingestion, can cause or contribute to ESRD more often than they are recorded. The incidence of ESRD has been increasing at a rate of up to 9% per year. The likely reasons for ESRD growth include decreased competing risk from other diseases, increased referral and acceptance of patients with advanced renal failure, and increased renal disease.
通过讨论目前已知的病因、可能未被归因的病因以及终末期肾病（ESRD）新发病例增加的原因，来深入了解ESRD的病因。ESRD的已知病因随时间和地区的不同而有所变化。在美国，糖尿病长期以来一直是ESRD最常见的已知病因，在1992年占新发病例的36%。相比之下，糖尿病性ESRD在其他国家则要少见得多。高血压和肾小球肾炎是ESRD接下来最常见的已知病因，但这些诊断不一定基于一致或统一的标准。在许多情况下，ESRD病因的错误分类是可能的。新出现的证据表明，其他一些病症，包括肾血管疾病和止痛药摄入，导致或促成ESRD的频率可能比记录的更高。ESRD 的发病率一直以每年高达9%的速度增长。ESRD病例增加的可能原因包括其他疾病的竞争风险降低、晚期肾衰竭患者转诊和收治的增加以及肾病的增多。
