Trends in Albuminuria and GFR Among Adolescents in the United States, 1988-2014.
Trends in Albuminuria and GFR Among Adolescents in the United States, 1988-2014.
复制标题
1988-2014 年美国青少年蛋白尿和 GFR 的趋势。
DOI：
10.1053/j.ajkd.2018.04.021
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Meda E. Pavkov
中科院分区：
文献类型：
--
作者：
S. Saydah;Hui Xie;G. Imperatore;N. R. Burrows;Meda E. Pavkov
理由及目的
RATIONALE & OBJECTIVE
Albuminuria and low estimated glomerular filtration rate (eGFR) define chronic kidney disease in adults and youth. Different from adults, the burden of abnormal kidney markers among youth in the general United States population is largely unknown.
STUDY DESIGN
Serial cross-sectional national surveys.
SETTING & PARTICIPANTS
Adolescents aged 12 to 18 years participating in the National Health and Nutrition Examination Surveys 1988 to 2014. Surveys were grouped into three 6-year periods.
PREDICTORS
Demographic and clinical determinants of kidney markers.
OUTCOME
Prevalence and trends in persistent albuminuria, low (< 60mL/min/1.73m2) and reduced (< 90mL/min/1.73m2) eGFRs.
ANALYTICAL APPROACH
Outcomes defined as persistent albumin-creatinine ratio ≥ 30mg/g (persistent albuminuria), eGFR < 90mL/min/1.73m2 (reduced kidney function), and eGFR < 60mL/min/1.73m2 (low kidney function). Multiple imputation analysis was used to estimate missing follow-up values of albuminuria.
RESULTS
Prevalences of persistent albuminuria were 3.64% (95% CI, 1.82%-5.46%) in 1988-1994 and 3.29% (95% CI, 1.94%-4.63%) in 2009-2014 (adjusted prevalence ratio, 0.93; 95% CI, 0.53-1.62; P=0.8 for trend). Prevalences of reduced eGFR were 31.46% (95% CI, 28.42%-34.67%) and 34.58% (95% CI, 32.07%-37.18%), respectively (adjusted prevalence ratio, 1.21; 95% CI, 1.00-1.46; P < 0.001 for trend). Prevalences of low eGFR were 0.32% (95% CI, 0.12%-0.84%) in 1988-1994 and 0.91% (95% CI, 0.58%-1.42%) in 2009-2014 (adjusted prevalence ratio, 3.10; 95% CI, 1.10-9.01; P = 0.09 for trend). Prevalences of albuminuria and/or low eGFR remained at 4.0% in 1988-1994 and 2009-2014 (adjusted prevalence ratio, 1.06; 95% CI, 0.64-1.77; P = 0.8 for trend).
LIMITATIONS
Persistent albuminuria data were based on imputed values (for second assessment of albuminuria) in 91% of participants; lack of second eGFR assessment to confirm sustained reduction in kidney function.
CONCLUSIONS
Albuminuria prevalence has not changed significantly in the US adolescent population between 1988 and 2014. Prevalences of both reduced and low eGFRs were higher in the most recent study period; however, < 1% of adolescents had low eGFRs.
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