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The Lancet:王海燕等对中国慢性肾脏病流行病学数据进行新调查

  1. The Lancet
  2. 慢性肾脏病
  3. 数据
  4. 流行病学

来源:北京大学医学部 2012-11-18 10:59

近日,国际著名杂志《柳叶刀》The Lancet在线刊登了北大医院肾脏内科王海燕教授的最新研究成果“中国慢性肾脏病流行病学调查”(Prevalence of chronic kidney disease in China: a cross-sectional survey),文章中,研究者对中国慢性肾脏病流行病进行了统计以及调查研究。

近日,国际著名杂志《柳叶刀》The Lancet在线刊登了北大医院肾脏内科王海燕教授的最新研究成果“中国慢性肾脏病流行病学调查”(Prevalence of chronic kidney disease in China: a cross-sectional survey),文章中,研究者对中国慢性肾脏病流行病进行了统计以及调查研究。

“中国慢性肾脏病流行病学调查”是由科技部“十一五”科技支撑计划资助、涉及全国13个省市、自治区的全国性横断面研究。该研究历时4年,对于全国近5万名18岁以上成年居民进行了慢性肾脏病的调查。研究采用多阶段分层抽样的设计方法获取能够代表中国成年人群的调查对象,应用基于肌酐的估计肾小球滤过率和尿白蛋白/肌酐比值评价有无肾脏病,并应用复合权重的统计学方法对于患病率进行校正、使之能够反映中国成年人群的情况。调查结果显示,我国成年人群中慢性肾脏病的患病率为10.8%,据此估计我国现有成年慢性肾脏病患者1.2亿;而慢性肾脏病的知晓率仅为12.5%。该调查还发现经济快速发展的农村地区居民成为慢性肾脏病的高发人群,推测与高血压、糖尿病等代谢性疾病的激增及医疗保健欠完善有关。

《柳叶刀》杂志为该研究论文配发题为《龙年伊始:中国是否将迎来慢性肾脏病的流行》的述评,对于研究的重要性给予高度评价。(生物谷Bioon.com)

Prevalence of chronic kidney disease in China: a cross-sectional survey

Luxia Zhang MD a *, Fang Wang MD a *, Prof Li Wang MD b †, Prof Wenke Wang MD c †, Prof Bicheng Liu MD d †, Prof Jian Liu MD e †, Prof Menghua Chen MD f †, Prof Qiang He MD g †, Prof Yunhua Liao MD h †, Prof Xueqing Yu MD i †, Prof Nan Chen MD j †, Prof Jian-e Zhang MD k, Prof Zhao Hu MD l, Prof Fuyou Liu MD m, Daqing Hong MD b, Lijie Ma MD c, Hong Liu MD d, Xiaoling Zhou MD f, Jianghua Chen MD g, Ling Pan MD h, Wei Chen MD i, Weiming Wang MD j, Prof Xiaomei Li MD a, Prof Haiyan Wang MD a

Background The prevalence of chronic kidney disease is high in developing countries. However, no national survey of chronic kidney disease has been done incorporating both estimated glomerular filtration rate (eGFR) and albuminuria in a developing country with the economic diversity of China. We aimed to measure the prevalence of chronic kidney disease in China with such a survey.

Methods We did a cross-sectional survey of a nationally representative sample of Chinese adults. Chronic kidney disease was defined as eGFR less than 60 mL/min per 1·73 m2 or the presence of albuminuria. Participants completed a lifestyle and medical history questionnaire and had their blood pressure measured, and blood and urine samples taken. Serum creatinine was measured and used to estimate glomerular filtration rate. Urinary albumin and creatinine were tested to assess albuminuria. The crude and adjusted prevalence of indicators of kidney damage were calculated and factors associated with the presence of chronic kidney disease analysed by logistic regression.

Findings 50 550 people were invited to participate, of whom 47 204 agreed. The adjusted prevalence of eGFR less than 60 mL/min per 1·73 m2 was 1·7% (95% CI 1·5—1·9) and of albuminuria was 9·4% (8·9—10·0). The overall prevalence of chronic kidney disease was 10·8% (10·2—11·3); therefore the number of patients with chronic kidney disease in China is estimated to be about 119·5 million (112·9—125·0 million). In rural areas, economic development was independently associated with the presence of albuminuria. The prevalence of chronic kidney disease was high in north (16·9% [15·1—18·7]) and southwest (18·3% [16·4—20·4]) regions compared with other regions. Other factors independently associated with kidney damage were age, sex, hypertension, diabetes, history of cardiovascular disease, hyperuricaemia, area of residence, and economic status.

Interpretation Chronic kidney disease has become an important public health problem in China. Special attention should be paid to residents in economically improving rural areas and specific geographical regions in China.

Funding The Ministry of Science and Technology (China); the Science and Technology Commission of Shanghai; the National Natural Science Foundation of China; the Department of Health, Jiangsu Province; the Sichuan Science and Technology Department; the Ministry of Education (China); the International Society of Nephrology Research Committee; and the China Health and Medical Development Foundation.

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