Undiagnosed and untreated chronic kidney disease and its impact on renal outcomes in the Japanese middle-aged general population
Undiagnosed and untreated chronic kidney disease and its impact on renal outcomes in the Japanese middle-aged general population
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DOI：
10.1136/jech-2019-212858
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发表时间：
2019-12-01
影响因子：
6.3
通讯作者：
Fukuma, Shingo
中科院分区：
文献类型：
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作者：
Yamada, Yukari;Ikenoue, Tatsuyoshi;Fukuma, Shingo
识别和监测早期慢性肾脏病（CKD）的有效性尚未得到充分认可。本研究量化了日本中年人群中未确诊的CKD患者，并阐明了未经治疗的CKD.Methods的潜在风险，我们纳入了71233名在2014年进行年度健康检查（AHC）的基线和随访蛋白尿和血清肌酸测量的个体。根据AHC数据，在AHC后6个月内就诊和未就诊的患者中，蛋白尿或估计肾小球滤过率（eGFR）> 3 mL/min/1.73m2/年或蛋白尿发生率> 3年的患者被确定为CKD。只有2.1%的未确诊的CKD患者在AHC后6个月内就医治疗。工具变量调整模型的组间风险差异显示，那些未经治疗的进展为肾脏疾病16.3%，往往比那些谁访问了医生的CKD treatment.Conclusion CKD未确诊的5.2%的中年一般人群。只有少数人去看医生治疗CKD。在筛选后的前6个月内接受CKD治疗的访视医生可能与肾脏疾病进展的风险较低相关。
Background The effectiveness of identifying and monitoring early-stage chronic kidney disease (CKD) is not fully recognised. This study quantified people with undiagnosed CKD among the middle-aged Japanese population and clarified potential risks of untreated CKD.Methods We included 71233 individuals who underwent annual health check-ups (AHC) in 2014 for both baseline and follow-up proteinuria and serum creatine measurements. CKD was identified by AHC data as proteinuria or estimated glomerular filtration rate (eGFR) 3mL/min/1.73m(2)/year or proteinuria incidence over 3years, between those who visited a physician for CKD treatment within 6 months after AHC and those who did not.Results CKD prevalence was 5.7% (5.2% undiagnosed and 0.5% diagnosed). Only 2.1% of the patients with undiagnosed CKD visited a physician for CKD treatment within 6 months after AHC. Between-group risk differences in instrumental variable adjustment models showed that those left untreated progressed to kidney diseases 16.3% more often than those who visited physicians for CKD treatment.Conclusion CKD was undiagnosed in 5.2% of the middle-aged general population. Only a few people visited physicians for CKD treatment. Visiting physicians for CKD treatment during the first 6 months after screening may be associated with a lower risk of kidney disease progression.