A systematic analysis of worldwide population-based data on the global burden of chronic kidney disease in 2010
2015; Elsevier BV; Volume: 88; Issue: 5 Linguagem: Inglês
10.1038/ki.2015.230
ISSN1523-1755
AutoresKatherine T. Mills, Yu Xu, Weidong Zhang, Joshua D. Bundy, Chung-Shiuan Chen, Tanika N. Kelly, Jing Chen, Jiang He,
Tópico(s)Healthcare Systems and Reforms
ResumoChronic kidney disease (CKD) is a major risk factor for endstage renal disease, cardiovascular disease, and premature death. Here we estimated the global prevalence and absolute burden of CKD in 2010 by pooling data from population- based studies. We searched MEDLINE (January 1990 to December 2014), International Society of Nephrology Global Outreach Program-funded projects, and bibliographies of retrieved articles and selected 33 studies reporting gender- and age-specific prevalence of CKD in representative population samples. The age-standardized global prevalence of CKD stages 1–5 in adults aged 20 and older was 10.4% in men (95% confidence interval 9.3–11.9%) and 11.8% in women (11.2–12.6%). This consisted of 8.6% in men (7.3–9.8%) and 9.6% in women (7.7–11.1%) in high-income countries, and 10.6% in men (9.4–13.1%) and 12.5% in women (11.8–14.0%) in low- and middle-income countries. The total number of adults with CKD was 225.7 million (205.7–257.4 million) men and 271.8 million (258.0–293.7 million) women. This consisted of 48.3 million (42.3–53.3 million) men and 61.7 million (50.4–69.9 million) women in high-income countries, and 177.4 million (159.2–215.9 million) men and 210.1 million (200.8–231.7 million) women in low- and middle-income countries. Thus, CKD is an important global-health challenge, especially in low- and middle-income countries. National and international efforts for prevention, detection, and treatment of CKD are needed to reduce its morbidity and mortality worldwide. Chronic kidney disease (CKD) is a major risk factor for endstage renal disease, cardiovascular disease, and premature death. Here we estimated the global prevalence and absolute burden of CKD in 2010 by pooling data from population- based studies. We searched MEDLINE (January 1990 to December 2014), International Society of Nephrology Global Outreach Program-funded projects, and bibliographies of retrieved articles and selected 33 studies reporting gender- and age-specific prevalence of CKD in representative population samples. The age-standardized global prevalence of CKD stages 1–5 in adults aged 20 and older was 10.4% in men (95% confidence interval 9.3–11.9%) and 11.8% in women (11.2–12.6%). This consisted of 8.6% in men (7.3–9.8%) and 9.6% in women (7.7–11.1%) in high-income countries, and 10.6% in men (9.4–13.1%) and 12.5% in women (11.8–14.0%) in low- and middle-income countries. The total number of adults with CKD was 225.7 million (205.7–257.4 million) men and 271.8 million (258.0–293.7 million) women. This consisted of 48.3 million (42.3–53.3 million) men and 61.7 million (50.4–69.9 million) women in high-income countries, and 177.4 million (159.2–215.9 million) men and 210.1 million (200.8–231.7 million) women in low- and middle-income countries. Thus, CKD is an important global-health challenge, especially in low- and middle-income countries. National and international efforts for prevention, detection, and treatment of CKD are needed to reduce its morbidity and mortality worldwide. Chronic kidney disease (CKD) is a major global health burden because of its high prevalence and associated risk of end-stage renal disease (ESRD), cardiovascular disease (CVD), and premature death.1.Jha V. Garcia-Garcia G. Iseki K. et al.Chronic kidney disease: global dimension and perspectives.Lancet. 2013; 382: 260-272Abstract Full Text Full Text PDF PubMed Scopus (2575) Google Scholar, 2.Go A.S. Chertow G.M. 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The crude prevalence of CKD stages 1–5 varied from 4.5% in South Korea to 25.7% in El Salvador in men, and from 4.1% in Saudi Arabia to 16.0% in Singapore in women; stages 3–5 varied from 1.3% in China to 15.4% in Nepal in men and from 1.7% in Singapore to 21.3% in Nepal in women.Table 1Characteristics of studiesCountry, yearStudy sampleSample sizeFemale, %Age, yearsAlbuminuria or proteinuria measurementeGFR equationCreatinine measurement methodsPrevalence of CKD stages 1-5, %aWhen standard errors were not reported, they were estimated as the square root of ([prevalence of CKD × (1−prevalence of CKD)]/sample size).Prevalence of CKD stages 3-5, %aWhen standard errors were not reported, they were estimated as the square root of ([prevalence of CKD × (1−prevalence of CKD)]/sample size).MenWomenMenWomenHigh-income countriesAustralia,9.White S.L. Polkinghorne K.R. Atkins R.C. et al.Comparison of the prevalence and mortality risk of CKD in Australia using the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study GFR estimating equations: the AusDiab (Australian Diabetes, Obesity and Lifestyle) Study.Am J Kidney Dis. 2010; 55: 660-670Abstract Full Text Full Text PDF PubMed Scopus (208) Google Scholar 2010National11,24755.1≥25—CKD-EPIModified Jaffé method4.9 (3.9–5.9)6.6 (4.2–9.0)Canada,10.Arora P. Vasa P. 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Arveiler D. et al.Assessment and characteristics of chronic renal insufficiency in France.Ann Cardiol Angeiol (Paris). 2012; 61 (in French): 239-244Crossref Scopus (25) Google Scholar 2012Regional472749.535–74—MDRDKinetic Jaffé method——6.4 (5.4–7.4)—Germany,14.Zhang Q.L. Koenig W. Raum E. et al.Epidemiology of chronic kidney disease: results from a population of older adults in Germany.Prev Med. 2009; 48: 122-127Crossref PubMed Scopus (49) Google Scholar 2009Regional980655.050–74—MDRDKinetic Jaffé method——14.5 (13.5–15.5)19.8 (18.7–20.8)Italy,15.Cirillo M. Laurenzi M. Mancini M. et al.Low glomerular filtration in the population: prevalence, associated disorders, and awareness.Kidney Int. 2006; 70: 800-806Abstract Full Text Full Text PDF PubMed Scopus (113) Google Scholar 2006Regional457454.518–95—MDRDKinetic Jaffé method——6.6 (2.4–10.8)6.2 (2.4–10.0)Italy,16.Gambaro G. Yabarek T. 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Boavida J.M. et al.Prevalence of chronic kidney disease and associated risk factors, and risk of end-stage renal disease: data from the PREVADIAB study.Nephron Clin Pract. 2011; 119: c35-c40Crossref PubMed Scopus (32) Google Scholar 2011National516759.820–79—MDRDKinetic Jaffé method——3.7 (28–4.6)7.8 (68–8.8)Saudi Arabia,23.Alsuwaida A.O. Farag Y.M.K. Al Sayyari A.A. et al.Epidemiology of chronic kidney disease in the Kingdom of Saudi Arabia (SEEK-Saudi Investigators) - a pilot study.Saudi J Kidney Dis Transplant. 2010; 21: 1066-1072Google Scholar 2010Regional49150.1≥18Urine dipstick testMDRDKinetic Jaffé method7.3 (4.0–10.7)4.1 (1.5–6.6)——Singapore,24.National Health Survey in Singapore 2010. 2010https://www.moh.gov.sg/content/moh_web/home/Publications/Reports/2011/national_health_survey2010.htmlGoogle Scholar 2011National433751.618–69—MDRDKinetic Jaffé method——2.8 (2.1–3.5)1.7 (1.2–2.2)Singapore,25.Sabanayagam C. Lim S.C. 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