The Future Burden of CKD in the United States: A Simulation Model for the CDC CKD Initiative
The Future Burden of CKD in the United States: A Simulation Model for the CDC CKD Initiative
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DOI：
10.1053/j.ajkd.2014.09.023
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发表时间：
2015-03-01
影响因子：
13.2
通讯作者：
Zhuo, Xiaohui
中科院分区：
文献类型：
--
作者：
Hoerger, Thomas J.;Simpson, Sean A.;Zhuo, Xiaohui
背景资料：认识慢性肾脏疾病（CKD），定义为肾损害或肾小球滤过率降低，在美国仍然很低，其未来的负担存在的估计很少studydesign：我们使用的CKD健康政策模型来模拟CKD的剩余终身发病率和项目的患病率在2020年和2030年的CKD。模拟样本基于1999年至2010年国家健康和营养检查调查的全国代表性数据。设置和人群：当前美国人口。模型、视角和时间轴：模拟模型随访当前年龄至死亡或90岁的个体。结局：剩余终生发病率代表在其一生中将发展为新CKD的人的预计百分比。未来患病率预计为2020年和2030年。测量：CKD的发生和进展是基于估计肾小球滤过率的年度递减，这取决于年龄和风险因素。对于基线时无CKD的30 - 49岁、50 - 64岁和65岁或以上的美国成年人，CKD的剩余终生发生率分别为54%、52%和42%，分别30岁及以上成人CKD患病率预计将从目前的13.2%增加到2020年的14.4%和2030年的16.7%。局限性：由于数据有限，我们的模拟模型估计是基于估计肾小球滤过率每年递减的假设。对于个人来说，CKD的终身风险很高，超过一半的30至64岁的美国成年人可能会发展CKD。了解CKD的终生发病率可以提高个人的意识，并鼓励他们采取措施预防CKD。从国家负担的角度来看，我们估计CKD的人群患病率将在未来几十年内增加，这表明应考虑制定干预措施以减缓CKD的发病和进展。(C)2015年，美国国家肾脏基金会（National Kidney Foundation，Inc.）爱思唯尔公司出版All rights reserved.
Background: Awareness of chronic kidney disease (CKD), defined by kidney damage or reduced glomerular filtration rate, remains low in the United States, and few estimates of its future burden exist.Study Design: We used the CKD Health Policy Model to simulate the residual lifetime incidence of CKD and project the prevalence of CKD in 2020 and 2030. The simulation sample was based on nationally representative data from the 1999 to 2010 National Health and Nutrition Examination Surveys.Setting & Population: Current US population.Model, Perspective, & Timeline: Simulation model following up individuals from current age through death or age 90 years.Outcomes: Residual lifetime incidence represents the projected percentage of persons who will develop new CKD during their lifetimes. Future prevalence is projected for 2020 and 2030.Measurements: Development and progression of CKD are based on annual decrements in estimated glomerular filtration rates that depend on age and risk factors.Results: For US adults aged 30 to 49, 50 to 64, and 65 years or older with no CKD at baseline, the residual lifetime incidences of CKD are 54%, 52%, and 42%, respectively. The prevalence of CKD in adults 30 years or older is projected to increase from 13.2% currently to 14.4% in 2020 and 16.7% in 2030.Limitations: Due to limited data, our simulation model estimates are based on assumptions about annual decrements in estimated glomerular filtration rates.Conclusions: For an individual, lifetime risk of CKD is high, with more than half the US adults aged 30 to 64 years likely to develop CKD. Knowing the lifetime incidence of CKD may raise individuals' awareness and encourage them to take steps to prevent CKD. From a national burden perspective, we estimate that the population prevalence of CKD will increase in coming decades, suggesting that development of interventions to slow CKD onset and progression should be considered. (C) 2015 by the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.