Cardiovascular risk factor burden, treatment, and control among adults with chronic kidney disease in the United States.
Cardiovascular risk factor burden, treatment, and control among adults with chronic kidney disease in the United States.
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DOI：
10.1016/j.ahj.2013.03.016
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发表时间：
2013-07
影响因子：
4.8
通讯作者：
Selvin, Elizabeth
中科院分区：
文献类型：
--
作者：
Foster, Meredith C.;Rawlings, Andreea M.;Marrett, Elizabeth;Neff, David;Willis, Kerry;Inker, Lesley A.;Coresh, Josef;Selvin, Elizabeth
心血管疾病是慢性肾病（CKD）患者的主要问题。我们评估了目前的心血管危险因素的负担和危险因素治疗和控制的差异，在一般美国成人人群的CKD状态。对2007-2010年国家健康和营养检查调查的10，741名20岁以上成年人进行的横断面研究。将患者分为三组：CKD 3-5期（估计肾小球滤过率[eGFR]<60 mL/min/1.73 m2），CKD 1-2期（尿白蛋白与肌酐比值≥ 30 mg/g且eGFR≥ 60 mL/min/1.73 m2）和无CKD。大多数患有CKD 3-5期（79.8%）和1-2期（59.1%）的成人具有≥2个心血管风险因素，显著高于无CKD的成人（32.7%，p<0.001）。糖尿病是最强相关的危险因素，对CKD 1-2期具有高度特异性（患病率[PR] 2.53，95%置信区间[CI] 2.21-2.89），对CKD 3-5期具有较低程度的特异性（PR 1.59，95%CI 1.38-1.84）。大多数有确诊危险因素的成年人报告使用药物控制危险因素，药物治疗在CKD患者中比无CKD患者更常见。然而，与没有CKD的人相比，CKD风险因素治疗的风险因素控制不良也很常见。与无CKD的成人相比，CKD 3-5期成人继续存在大量心血管风险因素负担，CKD 1-2期成人的程度较低。总体而言，CKD成人患者的最佳风险因素控制较低，这突出表明需要积极降低CKD成人患者的心血管风险。
Cardiovascular disease is a major concern in persons with chronic kidney disease (CKD). We assessed the current burden of cardiovascular risk factors and differences in risk factor treatment and control in the general U.S. adult population by CKD status. Cross-sectional study of 10,741 adults aged 20+ years from the 2007-2010 National Health and Nutrition Examination Survey. Persons were categorized into three groups: CKD Stages 3-5 (estimated glomerular filtration rate [eGFR]<60mL/min/1.73m2), CKD Stages 1-2 (urinary albumin-to-creatinine ratio≥30mg/g and eGFR≥60mL/min/1.73m2), and no CKD. The majority of adults with CKD Stages 3-5 (79.8%) and Stages 1-2 (59.1%) had ≥2 cardiovascular risk factors, substantially higher than adults without CKD (32.7%, p<0.001). Diabetes was the most strongly associated risk factor and was highly specific for CKD Stages 1-2 (prevalence ratio [PR] 2.53, 95% confidence interval [CI] 2.21-2.89) and, to a lesser extent, CKD Stages 3-5 (PR 1.59, 95%CI 1.38-1.84). Most adults with diagnosed risk factors reported medication use for risk factor control, and pharmacologic treatment was more common among those with than without CKD. However, poor risk factor control was also common among persons treated for risk factors with CKD compared to those without CKD. There continues to be a substantial cardiovascular risk factor burden among adults with CKD Stages 3-5 and, to a lesser extent, adults with CKD Stages 1-2, when compared to adults without CKD. Overall, optimal risk factor control is low in adults with CKD, highlighting the need for aggressive cardiovascular risk reduction in adults with CKD.
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影响因子：
16.2
作者：
American Diabetes Association
通讯作者：
American Diabetes Association
影响因子：
--
作者：
Foster, Meredith C.;Hwang, Shih-Jen;Fox, Caroline S.
通讯作者：
Fox, Caroline S.
影响因子：
168.9
作者：
Matsushita, Kunihiro;van der Velde, Marije;Astor, Brad C.;Woodward, Mark;Levey, Andrew S.;de Jong, Paul E.;Coresh, Josef;Gansevoort, Ron T.
通讯作者：
Gansevoort, Ron T.
影响因子：
120.7
作者：
Coresh, Josef;Selvin, Elizabeth;Levey, Andrew S.
通讯作者：
Levey, Andrew S.
影响因子：
39.2
作者：
Levey AS;Stevens LA;Schmid CH;Zhang YL;Castro AF 3rd;Feldman HI;Kusek JW;Eggers P;Van Lente F;Greene T;Coresh J;CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
通讯作者：
CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)