Determinants and burden of chronic kidney disease in the population-based CoLaus study: a cross-sectional analysis
Determinants and burden of chronic kidney disease in the population-based CoLaus study: a cross-sectional analysis
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DOI：
10.1093/ndt/gft206
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发表时间：
2013-09-01
影响因子：
6.1
通讯作者：
Bochud, Murielle
中科院分区：
文献类型：
--
作者：
Ponte, Belen;Pruijm, Menno;Bochud, Murielle
背景。慢性肾病（CKD）代表着日益增加的健康负担。我们介绍了基于人群的 CKD 患病率，并比较了 CKD 流行病学协作 (CKD-EPI) 和肾脏疾病饮食修改 (MDRD) 方程，以估计肾小球滤过率，使用修订后的 CKD 分类和三种蛋白尿类别。我们还探讨了与 CKD 相关的因素。方法。 CoLaus 于洛桑进行的基于瑞士人口的横断面研究（2003-2006 年）包括 2810 名男性和 3111 名女性，年龄在 35-75 岁之间。使用 CKD-EPI 和 MDRD 方程评估 CKD 患病率，并通过晨尿中的白蛋白与肌酐比率评估白蛋白尿。使用多变量逻辑回归分析 CKD 的决定因素。结果。所有阶段 CKD 的患病率 [95% 置信区间 (CI)] 在 CKD-EPI 中为 10.0% (9.2-10.8%)，在 MDRD 中为 13.8% (12.9-14.6%)。使用修订后的 CKD 分类，低、中、高和极高风险组 CKD-EPI 的患病率分别为 90.0%、8.46%、1.18% 和 0.35%。 MDRD 的相应值为 86.24、11.86、1.55 和 0.35%。使用修订后的分类，CKD-EPI 系统地将人群重新分类为比 MDRD 风险更低的类别。与女性相比，年龄和肥胖与男性 CKD 的相关性更强[比值比（95% CI）：每 10 年分别为 2.23（1.95；2.56）和 3.05（2.08；4.47）][分别为 1.46（1.29；1.65）和 1.78（1.30；2.44）]。高血压、2 型糖尿病、血清同型半胱氨酸和尿酸与男性和女性 CKD 呈独立正相关。结论。洛桑人口中有十分之一的成年人患有慢性肾病。 CKD-EPI 系统地将人们重新分类为 CKD 风险低于 MDRD 的风险类别。血清同型半胱氨酸和尿酸水平与 CKD 相关，与年龄、高血压和糖尿病等经典危险因素无关。
Background. Chronic kidney disease (CKD) represents an increasing health burden. We present the population-based prevalence of CKD and compare the CKD Epidemiology collaboration (CKD-EPI) and modification of diet in renal disease (MDRD) equations to estimate the glomerular filtration rate, using the revised CKD classification with three albuminuria classes. We also explore factors associated with CKD.Methods. The Swiss population-based, cross-sectional CoLaus study conducted in Lausanne (2003-2006) included 2810 men and 3111 women aged 35-75. CKD prevalence was assessed using CKD-EPI and MDRD equations and albuminuria estimated by the albumin-to-creatinine ratio in spot morning urine. Multivariate logistic regression was used to analyse determinants of CKD.Results. Prevalence [95% confidence interval (CI)] of all stages CKD was 10.0% (9.2-10.8%) with CKD-EPI and 13.8% (12.9-14.6%) with MDRD. Using the revised CKD classification, the prevalence of low-, medium-, high-and very high-risk groups was 90.0, 8.46, 1.18 and 0.35% with CKD-EPI, respectively. With MDRD, the corresponding values were 86.24, 11.86, 1.55 and 0.35%. Using the revised classification, CKD-EPI systematically reclassified people in a lower risk category than MDRD. Age and obesity were more strongly associated with CKD in men [odds ratio (95% CI): 2.23(1.95; 2.56) per 10 years and 3.05(2.08; 4.47), respectively] than in women [1.46 (1.29; 1.65) and 1.78 (1.30; 2.44), respectively]. Hypertension, type 2 diabetes, serum homocysteine and uric acid were positively independently associated with CKD in men and women.Conclusions. One in 10 adults suffers from CKD in the population of Lausanne. CKD-EPI systematically reclassifies people in a lower CKD risk category than MDRD. Serum homocysteine and uric acid levels are associated with CKD independently of classical risk factors such as age, hypertension and diabetes.