Trends in Prevalence of Chronic Kidney Disease in the United States.
Trends in Prevalence of Chronic Kidney Disease in the United States.
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DOI：
10.7326/m16-0273
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发表时间：
2016-10-04
影响因子：
39.2
通讯作者：
Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team
中科院分区：
文献类型：
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作者：
Murphy D;McCulloch CE;Lin F;Banerjee T;Bragg-Gresham JL;Eberhardt MS;Morgenstern H;Pavkov ME;Saran R;Powe NR;Hsu CY;Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team
慢性肾脏疾病(CKD)的流行趋势对卫生保健政策和规划非常重要。更新慢性肾脏病患病率的趋势。重复横断面研究。1988-94年和1999年至2012年每两年进行一次全国健康和营养检查调查。20岁或20岁以上的成年人。慢性肾小球滤过率(GFR)根据慢性肾脏疾病-流行病学协作(CKD-EPI)方程估计，定义为CKD(3-4期)，由校准的血清肌酐测量(EGFR 15-59ml/min/1.73m2)。扩大后的慢性肾脏病定义还包括表皮生长因子受体≥为60ml/分钟/1.73m2和一次性尿白蛋白/肌酐比值≥为30 mg/g的人。3-4期慢性肾脏病的未调整患病率在20世纪90年代末至2000年初出现上升。然而，自2003年至2004年以来，3-4期慢性肾脏病的患病率总体上已基本稳定(例如，2003-04年3-4期慢性肾脏病的患病率为6.9%，2011年-12年为6.9%)。在控制了年龄、性别、种族/民族和糖尿病状况后，3-4期CKD的调整患病率总体上与2003-04和2011-12相比几乎没有差异(p=0.26)。自2000年初以来慢性肾脏病的患病率没有增加，S在大多数亚组中观察到，慢性肾脏病的定义扩大了，包括有较高的表皮生长因子受体但有蛋白尿者。每名受试者只测量一次血肌酐和蛋白尿。与之前的趋势相反，在最近十年中，美国总体人口中3-4期CKD的患病率没有明显增加。
Trends in the prevalence of chronic kidney disease (CKD) are important for health-care policy and planning. To update trends in CKD prevalence. Repeated cross-sectional study. National Health and Nutrition Examination Survey (NHANES) in 1988–94 and every two years from 1999 to 2012. Adults 20 years or older. CKD (stages 3–4) was defined using glomerular filtration rate (GFR) estimated with the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation from calibrated serum creatinine measurements (eGFR 15–59 ml/min/1.73m2). An expanded definition of CKD also included persons with an eGFR ≥60 ml/min/1.73m2 and a one-time urine albumin-to-creatinine ratio ≥30 mg/g. An increase in the unadjusted prevalence of stages 3–4 CKD occurred from the late 1990s to the early 2000’s. Since 2003–04, however, the prevalence of stages 3–4 CKD overall has largely stabilized (e.g. 6.9% prevalence of stage 3–4 CKD in 2003–04 and 6.9% prevalence in 2011–12). There was little difference in adjusted prevalence of stage 3–4 CKD overall comparing 2003–04 and 2011–12 after controlling for age, sex, race/ethnicity, and diabetes mellitus status (p=0.26). Lack of increase in CKD prevalence since the early 2000’s was observed in most subgroups and with an expanded definition of CKD which included persons with higher eGFRs but with albuminuria. Serum creatinine and albuminuria were measured only once in each subject. In a reversal of prior trends, there has been no appreciable increase in the prevalence of stages 3–4 CKD in the U.S. population overall during the most recent decade.