Change in prevalence of chronic kidney disease in England over time: comparison of nationally representative cross-sectional surveys from 2003 to 2010.
Change in prevalence of chronic kidney disease in England over time: comparison of nationally representative cross-sectional surveys from 2003 to 2010.
复制标题
DOI：
10.1136/bmjopen-2014-005480
复制
发表时间：
2014-09-29
期刊：
影响因子：
2.9
通讯作者：
Moon G
中科院分区：
文献类型：
--
作者：
Aitken GR;Roderick PJ;Fraser S;Mindell JS;O'Donoghue D;Day J;Moon G
确定英国慢性肾脏病（CKD）的患病率是否随时间而变化。英国国家代表性健康调查（HSE）随机样本的横断面分析。英格兰2003年和2009/2010年。13896名16岁以上的成年人参加了HSE，调整了抽样和无应答，2009/2010年调查合并。 2003年至2009/2010年，基于在单个实验室中使用同位素稀释质谱法可追溯酶测定法进行的单次血清肌酐测量，估计肾小球滤过率（eGFR）<60 mL/min/1.73 m2（作为3-5期CKD的替代指标）的患病率变化; eGFR使用肾脏疾病改良饮食（MDRD）和慢性肾脏疾病流行病学协作组（CKDEPI）eGFR公式得出。 多变量逻辑回归建模，以调整社会人口统计学和临床因素（体重指数、高血压、糖尿病、血脂）的时间变化。对2003年HSE血清肌酐应用校正因子，以解释储存效应。对于两种公式，除65-74岁的男性外，每个年龄和性别组的低eGFR（<60）的全国患病率都有所下降。在此期间，肥胖症和糖尿病患病率上升，而高血压患病率下降。人口统计学和临床因素的调整导致调查期间的CKD显着下降。使用MDRD方程比较2009/2010年与2003年，eGFR <60 mL/min/1.73 m2的完全校正OR为0.75（0.61至0.92），使用CKDEPI方程为0.73（0.57至0.93），两者相似。 在这7年期间，尽管肥胖和糖尿病（CKD的两个主要原因）的患病率上升，但英格兰指示CKD的低eGFR的患病率似乎有所下降。高血压患病率下降，血压控制得到改善，但这似乎并不能解释下降的原因。需要定期评估未来HSE的eGFR和白蛋白尿，以评估CKD的趋势。
To determine whether the prevalence of chronic kidney disease (CKD) in England has changed over time. Cross-sectional analysis of nationally representative Health Survey for England (HSE) random samples. England 2003 and 2009/2010. 13 896 adults aged 16+ participating in HSE, adjusted for sampling and non-response, 2009/2010 surveys combined. Change in prevalence of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 (as proxy for stage 3–5 CKD), from 2003 to 2009/2010 based on a single serum creatinine measure using an isotope dilution mass spectrometry traceable enzymatic assay in a single laboratory; eGFR derived using Modified Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKDEPI) eGFR formulae. Multivariate logistic regression modelling to adjust time changes for sociodemographic and clinical factors (body mass index, hypertension, diabetes, lipids). A correction factor was applied to the 2003 HSE serum creatinine to account for a storage effect. National prevalence of low eGFR (<60) decreased within each age and gender group for both formulae except in men aged 65–74. Prevalence of obesity and diabetes increased in this period, while there was a decrease in hypertension. Adjustment for demographic and clinical factors led to a significant decrease in CKD between the surveyed periods. The fully adjusted OR for eGFR <60 mL/min/1.73 m2 was 0.75 (0.61 to 0.92) comparing 2009/2010 with 2003 using the MDRD equation, and was similar using the CKDEPI equation 0.73 (0.57 to 0.93). The prevalence of a low eGFR indicative of CKD in England appeared to decrease over this 7-year period, despite the rising prevalence of obesity and diabetes, two key causes of CKD. Hypertension prevalence declined and blood pressure control improved but this did not appear to explain the fall. Periodic assessment of eGFR and albuminuria in future HSEs is needed to evaluate trends in CKD.