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

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• 作者：Luxia Zhang ; MD^a ; ^* ; Fang Wang ; MD^a ; ^* ; Prof Li Wang ; MD^b ; ^&dagger ; ; Prof Wenke Wang ; MD^c ; ^&dagger ; ; Prof Bicheng Liu ; MD^d ; ^&dagger ; ; Prof Jian Liu ; MD^e ; ^&dagger ; ; Prof Menghua Chen ; MD^f ; ^&dagger ; ; Prof Qiang He ; MD^g ; ^&dagger ; ; Prof Yunhua Liao ; MD^h ; ^&dagger ; ; Prof Xueqing Yu ; MDⁱ ; ^&dagger ; ; Prof Nan Chen ; MD^j ; ^&dagger ; ; 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 ; MDⁱ ; Weiming Wang ; MD^j ; Prof Xiaomei Li ; MD^a ; Prof Haiyan Wang ; MD^a ; ^{why@bjmu.edu.cn}
• 刊名：The Lancet
• 出版年：2012
• 出版时间：3-9 March, 2012
• 年：2012
• 卷：379
• 期：9818
• 页码：815-822
• 全文大小：97 K

文摘

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Summary

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?50 people were invited to participate, of whom 47?04 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.