摘要
目的通过横断面调查了解社区成年慢性肾脏病(CKD)高危人群的CKD患病率,分析探究CKD的筛查策略。方法对2011年3月至2014年11月北京市区13 309例社区成年CKD高危患者采集病史,进行尿常规、血清肌酐检测,计算肾小球滤过率(GFR),评估CKD的患病率。结果确诊CKD患者4807例,CKD患病率36.1%。女性高危人群的CKD患病率明显高于男性(38.9%对32.9%,P<0.05);≥60岁老年人群CKD患病率明显高于<60岁人群(43.7%对22.0%,P<0.01)。有高血压且有糖尿病的人群CKD患病率(53.5%)高于仅有高血压(45.5%)或仅有糖尿病(43.7%)的人群以及总人群(36.1%)(P<0.05)。无高血压且无糖尿病的人群,CKD患病率(16.1%)明显低于仅有高血压或仅有糖尿病的人群、总人群及有高血压且有糖尿病的人群(P<0.01)。有高血压或有糖尿病的人群,CKD患病率高于总人群(P<0.05)。以同样的费用,只筛查高血压或糖尿病人群,筛出的患者数量是筛查全人群的4.5倍。结论社区CKD高危人群,特别是高血压、糖尿病人群的CKD患病率明显高于普通人群。在筛查条件有限的情况下,最经济有效的CKD筛查策略应该是筛查患有高血压或糖尿病的社区高危人群。
Objective To investigate the prevalence of chronic kidney disease (CKD)in adult high-risk population in community, and to analyze the screeningstrategy of CKD.Methods A total of 13 309 adult high-risk people of CKD in Beijing communities were included and their medical history was collected,urinary routine test and serum creatinine were determined,GFR was calculated,and the prevalence of CKD was evaluated.Results Totally 4807 patients were diagnosed with CKD.The prevalence of CKD was 36.1%. The prevalence of CKD in high-risk population was significantly higher in female than in male(38.9%vs 32.9%,P<0.05).The prevalence of CKD in patients ≥60-year-old was significantly higher than that in patients <60-year-old(43.7% vs 22.0%,P<0.01).The prevalence of CKD in people with hypertension and diabetes mellitus was higher than that in people with hypertension or diabetes mellitus and the general population (P<0.05).The prevalence of CKD in non-hypertensive and non-diabetic population was significantly lower than that in only hypertensive or diabetic population,total population and people with hypertension and diabetes mellitus (P<0.01). The prevalence of CKD in people with hypertension or diabetes mellitus was higher than that in the general population(P<0.05).At the same cost,the number of CKD patients diagnosed from patients with hypertension or diabetes was 4.5 times that of those from whole population..Conclusion The prevalence of CKD in the high-risk population in community,especially in the population with hypertension or diabetes,was significantly higher than that in the general population.In the case of limited screening conditions,the most cost-effective screening strategy is to screen the patients of CKD from the population with hypertension or diabetes in community.
作者
林雅慧
刘玉红
王宓
左力
LIN Ya-hui;LIU Yu-hong;WANG Mi;ZUO Li(Department of Nephrology,Peking University People's Hospital,Beijing 100044,China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2018年第12期1169-1172,共4页
Chinese Journal of Practical Internal Medicine
基金
中华医学会临床医学科研专项资金(09010050160)
关键词
慢性肾脏病
筛查策略
社区高危人群
患病率
chronic kidney disease
screening strategy
high-risk population in community
prevalence
