High burden and unmet patient needs in chronic kidney disease.
High burden and unmet patient needs in chronic kidney disease.
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DOI：
10.2147/ijnrd.s37766
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发表时间：
2012
影响因子：
2
通讯作者：
Copley-Merriman C
中科院分区：
文献类型：
--
作者：
Braun L;Sood V;Hogue S;Lieberman B;Copley-Merriman C
慢性肾脏病（CKD）是一种复杂的使人衰弱的疾病，影响全球7000多万人。随着老年人群中糖尿病、高血压和心血管疾病等危险因素的患病率增加，预计CKD患病率也将增加。提高卫生保健团队（患者、临床医生和支付者）对CKD总体负担的认识和理解是有必要的，以便改善整体护理和治疗管理。这篇关于CKD负担的综述总结了CKD的临床、人文和经济负担的现有证据，以及目前尚未满足的新治疗需求，并作为总体负担的资源。不同国家的CKD患病率差异很大，取决于患者的特征。包括糖尿病、高血压、心血管疾病和充血性心力衰竭在内的风险因素的患病率在估计肾小球滤过率（eGFR）较低的患者中明显较高，并导致高度复杂的CKD患者人群。随着CKD严重程度的增加，患者健康相关的生活质量随之下降，医疗保健资源的使用增加，成本也在不断上升。在目前的治疗中，近一半的患者进展为不利的肾脏和心血管结局。尽管需要阻止肾脏恶化的治愈性治疗，但正在研究的用于减缓肾脏恶化的CKD的创新药物，如阿曲生坦，甲基巴多索龙和球形碳吸附剂，可能会为患者提供更健康和更有成效的生活。
Chronic kidney disease (CKD) is a complex debilitating condition affecting more than 70 million people worldwide. With the increased prevalence in risk factors such as diabetes, hypertension, and cardiovascular disease in an aging population, CKD prevalence is also expected to increase. Increased awareness and understanding of the overall CKD burden by health care teams (patients, clinicians, and payers) is warranted so that overall care and treatment management may improve. This review of the burden of CKD summarizes available evidence of the clinical, humanistic, and economic burden of CKD and the current unmet need for new treatments and serves as a resource on the overall burden. Across countries, CKD prevalence varies considerably and is dependent upon patient characteristics. The prevalence of risk factors including diabetes, hypertension, cardiovascular disease, and congestive heart failure is noticeably higher in patients with lower estimated glomerular filtration rates (eGFRs) and results in highly complex CKD patient populations. As CKD severity worsens, there is a subsequent decline in patient health-related quality of life and an increased use of health care resources as well as burgeoning costs. With current treatment, nearly half of patients progress to unfavorable renal and cardiovascular outcomes. Although curative treatment that will arrest kidney deterioration is desired, innovative agents under investigation for CKD to slow kidney deterioration, such as atrasentan, bardoxolone methyl, and spherical carbon adsorbent, may offer patients healthier and more productive lives.