Wang Haiyan, a new survey of epidemiological data of chronic kidney disease in China

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The international famous magazine "Lancet" The Lancet published an online survey Chinese the epidemiology of chronic kidney disease of the l

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The international famous magazine "Lancet" The Lancet published an online survey Chinese the epidemiology of chronic kidney disease of the latest research results of Nephrology Peking University Hospital professor Wang Haiyan "(Prevalence of chronic kidney disease in China: a cross-sectional survey), in the article, the researchers conducted statistics and Research on epidemiology of chronic kidney disease China.

Epidemiological survey of chronic kidney disease in China is supported by the Ministry of science and technology in 11th Five-Year, and it is a cross sectional study involving 13 provinces and autonomous regions in china. The study, which lasted 4 years, was conducted to investigate the prevalence of chronic kidney disease in nearly 50 thousand adults over the age of 18. Study on the design method of multi stage stratified sampling survey to obtain objects to represent the China adult population, with an estimated glomerular filtration rate of creatinine and urinary albumin / creatinine ratio evaluation based on the evidence of kidney disease, statistical methods and the application of composite weights were adjusted, which can reflect the Chinese adult population for prevalence rate. The results showed that the prevalence rate of chronic kidney disease among the adult population in China was 10.8%, which was estimated to be about 120 million of adult patients with chronic kidney disease in China, while the awareness rate of chronic kidney disease was only about 12.5%. The survey also found that the rapid economic development of rural residents to become a high incidence of chronic kidney disease, speculated that high blood pressure, diabetes and other metabolic diseases and the lack of health care.

"Lancet" magazine as the research paper entitled "issued at the beginning of the Dragon: a review of whether Chinese will usher in the epidemic of chronic kidney disease", to give a high evaluation for the importance of the study.

At the beginning of the year of the dragon, China will usher in epidemic of chronic kidney disease Csaba P Kovesdy, Kamyar Kalantar-Zadeh

Over the past ten years, China's development has attracted worldwide attention, and has posed a challenge to the economic dominance of Western Europe and the United states. This brought to the world the compass, gunpowder and printing of the country has been in the steel and energy consumption, mobile phones and car sales over the United States and Europe, is expected to 2018 and 2023 respectively in the gross domestic product GDP and the level of consumption over the United states. Unfortunately, not every aspect of economic development is satisfactory. Life has become increasingly rich, followed by eating habits and obesity is not healthy, which accounted for the proportion of flat with the developed countries, and unhealthy diet and obesity are the main driving factors, and increased the rate of prevalence of diabetes and hypertension so as Chinese and the United States, Britain and other developed countries, become chronic kidney the high incidence of disease.

The epidemiological investigation in Chinese chronic kidney disease, and no investigation similar to the health of the national health and Nutrition Survey Center or Norway Nord Trondelag County Survey Center, so far no representative surveys. Professor Zhang Luxia and colleagues published the first comprehensive research results in the "Lancet" magazine, the study used a complex statistical investigation method, preliminary exploration of the prevalence of chronic kidney disease China, which concludes national representative. The results are noteworthy in many ways. In China, the prevalence of chronic kidney disease (adjusted for 10.8%, 95%CI is 10.2-11.3%; equivalent to about 119 million 500 thousand people) is far higher than that seen in the United States (26 million 300 thousand). Chinese in most patients with chronic kidney disease is diagnosed by proteinuria (adjusted prevalence rate of 9.4%, 95%CI 8.9-10.0), a small number is due to the estimated glomerular filtration rate (eGFR) < 60 mL/min /1.73 M2 (1.7%, 1.5-1.9) was diagnosed, and even use the underestimation of eGFR equation. Although the urinary protein as a marker of kidney injury is more reliable than the serum creatinine concentration was calculated according to the eGFR, but the number of such high display may still be overestimated (because only to distinguish a method), or in accordance with the investigators say, recently Chinese economic prosperity led to the early stage of chronic kidney disease prevalence is higher. The later is expected to be higher (i.e., low eGFR and end-stage renal disease). If the authors are right, the results will indicate a significant public health problem in China, and the number of medical resources in patients with advanced chronic kidney disease will increase exponentially.

The future seems to be more worrying if it takes into account the other important situation, the regional variations in the prevalence of chronic kidney disease in China and urban rural differences. Compared with urban patients, patients in rural areas have lower education level, poor control of hypertension, lack of awareness of diabetes, high incidence of proteinuria. Therefore, in the near future in the current health care system is not sufficient to provide such services in the region, there may be a large number of patients requiring renal replacement therapy.

Professor Zhang and colleagues have some limitations. According to the classification results of kidney dialysis / opinion control association, the value of cutoffs classification of chronic kidney disease can lead to the result contains a large number of early symptoms of patients, and these patients may have no real kidney disease, in particular those with normal kidney function but because of diet in renal disease study estimated glomerular filtration rate the crowd. In addition to the classification of healthy patients as a consequence of a serious illness, this overestimation may also lead to unnecessary pessimistic predictions of the prevalence of chronic kidney disease and end-stage renal disease. In China, because of the best time of dialysis (early or late) uncertainty and mortality of different ethnic groups (in the United States, African Americans than whites have significantly lower mortality and higher incidence of end-stage renal disease), also increased the burden of difficult to evaluate after dialysis. Therefore, follow-up studies should be done to confirm the results, a more detailed understanding of specific areas caused by the factors of chronic kidney disease, more important is to determine whether the prevalence of chronic kidney disease and patients with a reduced eGFR ratio will further increase.

Although there are limitations, but the study of Professor Zhang and his colleagues to the relevant government departments Chinese and health regulators sounded the alarm, make positive and effective measures to prevent chronic kidney disease in the future is imperative to increase the prevalence rate.

 

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