Prevalence of chronic kidney disease in the community using data from OxRen: a UK population-based cohort study
Prevalence of chronic kidney disease in the community using data from OxRen: a UK population-based cohort study
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DOI：
10.3399/bjgp20x708245
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发表时间：
2020-04-01
影响因子：
5.9
通讯作者：
Hobbs, F. D. Richard
中科院分区：
文献类型：
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作者：
Hirst, Jennifer A.;Hill, Nathan;Hobbs, F. D. Richard
背景慢性肾脏病（CKD）是一种无症状的肾功能减退的疾病，AimTo establish undiagnosed and overall CKD prevalence using a cross-sectional analysis.Design and settingLongitudinal cohort study in UK primary care. Method 60岁以上的参与者被邀请参加CKD筛查访视，以确定他们是否有肾功能下降（估计肾小球滤过率[eGFR] = 3 mg/mmol）。那些患有CKD、低eGFR、蛋白尿证据或两次筛查试验阳性的患者参加了基线评估结果共招募3207名参与者，其中861人参加了基线评估，CKD队列包括327名现有CKD患者，257名通过筛查确诊的CKD患者（CKD患病率为18.2%，95%可信区间[CI] = 16.9 ~ 19.6），277例有临界/一过性肾功能下降。在CKD队列中，54.4%为女性，平均标准差（SD）年龄为74.0（SD 6.9）岁，平均eGFR为58.0（SD 18.4）ml/min/1.73 m2。在确诊的584例CKD患者中，44.0%通过筛查确诊。超过一半的CKD队列（51.9%，447/861）在基线评估时属于CKD 3-5期，CKD 3-5期的总体患病率为13.9%（95% CI = 12.8 - 15.1）。在60-75岁年龄组中，使用肾脏疾病饮食改良（MDRD）方程的eGFR降低人数多于使用CKD流行病学协作组（CKD-EPI）方程的eGFR降低人数，而在>= 80岁年龄组中，使用CKD-EPI的eGFR降低人数更多。在年龄>60岁的参与者中，CKD 1-5期的患病率为18.2%。随访将提供关于年发病率、CKD进展率、快速进展的决定因素和心血管事件预测因素的数据。
BackgroundChronic kidney disease (CKD) is a largely asymptomatic condition of diminished renal function, which may not be detected until advanced stages without screening.AimTo establish undiagnosed and overall CKD prevalence using a cross-sectional analysis.Design and settingLongitudinal cohort study in UK primary care.MethodParticipants aged >= 60 years were invited to attend CKD screening visits to determine whether they had reduced renal function (estimated glomerular filtration rate [eGFR] = 3 mg/mmol). Those with existing CKD, low eGFR, evidence of albuminuria,or two positive screening tests attended a baseline assessment (CKD cohort).ResultsA total of 3207 participants were recruited and 861 attended the baseline assessment.The CKD cohort consisted of 327 people with existing CKD, 257 people with CKD diagnosed through screening (CKD prevalence of 18.2%,95% confidence interval [CI] = 16.9 to 19.6), and 277 with borderline/transient decreased renal function. In the CKD cohort, 54.4% were female,mean standard deviation (SD) age was 74.0 (SD 6.9) years, and mean eGFR was 58.0 (SD 18.4)ml/min/1.73 m(2). Of the 584 with confirmed CKD, 44.0% were diagnosed through screening. Overhalf of the CKD cohort (51.9%, 447/861) fell into CKD stages 3-5 at their baseline assessment,giving an overall prevalence of CKD stages 3-5 of 13.9% (95% CI = 12.8 to 15.1). More people had-reduced eGFR using the Modification of Diet in Renal Disease (MDRD) equation than with CKD Epidemiology Collaboration (CKD-EPI) equation in the 60-75-year age group and more had reduced eGFR using CKD-EPI in the >= 80-year age group.ConclusionThis study found that around 44.0% of people living with CKD are undiagnosed without screening, and prevalence of CKD stages 1-5 was 18.2% in participants aged >60 years. Follow-up will provide data on annual incidence, rate of CKD progression, determinants of rapid progression,and predictors of cardiovascular events.