Global Prevalence of Chronic Kidney Disease - A Systematic Review and Meta-Analysis.
Global Prevalence of Chronic Kidney Disease - A Systematic Review and Meta-Analysis.
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DOI：
10.1371/journal.pone.0158765
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Hobbs FD
中科院分区：
文献类型：
--
作者：
Hill NR;Fatoba ST;Oke JL;Hirst JA;O'Callaghan CA;Lasserson DS;Hobbs FD
慢性肾脏疾病（CKD）是一种全球性的健康负担，对卫生系统造成很高的经济成本，是心血管疾病（CVD）的独立风险因素。CKD的所有阶段都与心血管发病率、过早死亡和/或生活质量下降的风险增加相关。CKD通常无症状，直到晚期，并且缺乏准确的患病率数据。因此，我们试图确定全球CKD的患病率，按阶段，地理位置，性别和年龄。通过在8个数据库中进行文献检索，对估计普通人群中CKD患病率的观察性研究进行了系统综述和荟萃分析。我们使用随机效应模型评估汇总数据。在5，842篇潜在文章中，纳入了100项不同质量的研究，包括6，908，440例患者。5期CKD的总体平均（95%CI）患病率为13.4%（11.7 - 15.1%），3-5期为10.6%（9.2 - 12.2%）。按研究质量加权并不影响患病率估计。按分期列出的CKD患病率为第1期（eGFR>90+ACR>30）：3.5%（2.8 - 4.2%）; 2期（eGFR 60-89+ACR>30）：3.9%（2.7 - 5.3%）; 3期（eGFR 3 - 0 -59）：7.6%（6.4 - 8.9%）; 4期=（eGFR 29-15）：0.4%（0.3 - 0.5%）;和5期（eGFR<15）：0.1%（0.1 - 0.1%）。CKD的全球患病率较高，一致的估计全球CKD患病率为11 - 13%，大多数为3期。未来的研究应评估可大规模实施的干预策略，以延迟CKD的进展并改善CVD结局。
Chronic kidney disease (CKD) is a global health burden with a high economic cost to health systems and is an independent risk factor for cardiovascular disease (CVD). All stages of CKD are associated with increased risks of cardiovascular morbidity, premature mortality, and/or decreased quality of life. CKD is usually asymptomatic until later stages and accurate prevalence data are lacking. Thus we sought to determine the prevalence of CKD globally, by stage, geographical location, gender and age. A systematic review and meta-analysis of observational studies estimating CKD prevalence in general populations was conducted through literature searches in 8 databases. We assessed pooled data using a random effects model. Of 5,842 potential articles, 100 studies of diverse quality were included, comprising 6,908,440 patients. Global mean(95%CI) CKD prevalence of 5 stages 13·4%(11·7–15·1%), and stages 3–5 was 10·6%(9·2–12·2%). Weighting by study quality did not affect prevalence estimates. CKD prevalence by stage was Stage-1 (eGFR>90+ACR>30): 3·5% (2·8–4·2%); Stage-2 (eGFR 60–89+ACR>30): 3·9% (2·7–5·3%); Stage-3 (eGFR 30–59): 7·6% (6·4–8·9%); Stage-4 = (eGFR 29–15): 0·4% (0·3–0·5%); and Stage-5 (eGFR<15): 0·1% (0·1–0·1%). CKD has a high global prevalence with a consistent estimated global CKD prevalence of between 11 to 13% with the majority stage 3. Future research should evaluate intervention strategies deliverable at scale to delay the progression of CKD and improve CVD outcomes.