流行病学
这是一种经常到了晚期才得以确诊的常见疾病。据估计,世界范围内约有 9%-13% 的成人患有慢性肾脏病。[3]Webster AC, Nagler EV, Morton RL, et al. Chronic kidney disease. Lancet. 2017 Mar 25;389(10075):1238-52. http://www.ncbi.nlm.nih.gov/pubmed/27887750?tool=bestpractice.com [4]Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease - a systematic review and meta-analysis. PLoS One. 2016 Jul 6;11(7):e0158765. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158765 http://www.ncbi.nlm.nih.gov/pubmed/27383068?tool=bestpractice.com [5]GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020 Feb 29;395(10225):709-33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049905/ http://www.ncbi.nlm.nih.gov/pubmed/32061315?tool=bestpractice.com 2017 年,估算的全球 CKD 1-2 期患病率占 5%,3 期占 3.9%,4 期占 0.16%,5 期占 0.07%,其中进行透析的患者占 0.041%,肾移植患者占 0.011%。[5]GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020 Feb 29;395(10225):709-33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049905/ http://www.ncbi.nlm.nih.gov/pubmed/32061315?tool=bestpractice.com 目前认为 CKD 不断上升的发病率与以下因素相关:人口的老龄化;成年群体中最常见的两大病因,即糖尿病和高血压的高发病率;以及局灶性节段性肾小球硬化症等肾小球疾病发病率的上升。[4]Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease - a systematic review and meta-analysis. PLoS One. 2016 Jul 6;11(7):e0158765. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158765 http://www.ncbi.nlm.nih.gov/pubmed/27383068?tool=bestpractice.com [6]GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov 10;392(10159):1789-1858. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6227754/ http://www.ncbi.nlm.nih.gov/pubmed/30496104?tool=bestpractice.com [7]Rosenberg AZ, Kopp JB. Focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2017 Mar 7;12(3):502-17. http://cjasn.asnjournals.org/content/12/3/502.long http://www.ncbi.nlm.nih.gov/pubmed/28242845?tool=bestpractice.com 黑种人、西班牙人以及家族成员中有确诊肾脏疾病的个体,相较于一般人群发病率更高。[8]Myers OB, Pankratz VS, Norris KC, et al. Surveillance of CKD epidemiology in the US - a joint analysis of NHANES and KEEP. Sci Rep. 2018 Oct 26;8(1):15900. https://www.nature.com/articles/s41598-018-34233-w http://www.ncbi.nlm.nih.gov/pubmed/30367154?tool=bestpractice.com [9]McClellan WM, Satko SG, Gladstone E, et al. Individuals with a family history of ESRD are a high-risk population for CKD: implications for targeted surveillance and intervention activities. Am J Kidney Dis. 2009 Mar;53(3 suppl 3):S100-6. http://www.ncbi.nlm.nih.gov/pubmed/19231753?tool=bestpractice.com 此外,曾患急性肾损伤的人群是未来罹患慢性肾脏损伤以及终末期肾脏疾病风险最高的群体。[10]Coca SG, Singanamala S, Parikh CR. Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis. Kidney Int. 2012 Mar;81(5):442-8. https://www.kidney-international.org/article/S0085-2538(15)55323-4/fulltext http://www.ncbi.nlm.nih.gov/pubmed/22113526?tool=bestpractice.com
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