米国における慢性腎臓病の流行

Josef Coresh¹, Elizabeth Selvin, Lesley A Stevens

¹Department of Epidemiology, Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland 21287, USA. coresh@jhu.edu

JAMA

|November 8, 2007

まとめ

米国における慢性腎臓病 (CKD) の罹患率は,1988年~1994年と1999年~2004年の間に増加した. CKDの罹患率の上昇は,糖尿病と高血圧の発生率の増加と関連しています.

科学分野:

ネフロロジーはネフロロジーを用います.
公衆衛生は公衆衛生である.
エピデミオロジーエピデミオロジー

背景:

米国では腎不全の発生率が上昇しています.
慢性腎臓病 (CKD) の早期段階における罹患率の変化は不明である.

研究の目的:

米国におけるCKDの推定罹患率を更新するために.

主な方法:

NHANES 1988-1994年と1999-2004年のデータを横断分析した.
慢性腎臓病の罹患率は,アルブミヌリアが持続し,推定グローメルーラフィルタレーション率 (GFR) が低下することで決定される.
GFRは,腎臓病の研究の簡略化された食事の変更方程式を用いて推定された.

主要な成果:

CKDの罹患率は10.0% (1988年−1994年) から13.1% (1999年−2004年) に増加した.
アルブミヌーリアと低GFRの罹患率は著しく上昇した.
糖尿病と高血圧の罹患率の増加は,部分的にアルブミヌーリアの増加とGFRの低下を説明します.

結論:

米国のCKDの罹患率は,1988年から1994年に比べて1999年から2004年の間に高くなっています.
糖尿病と高血圧の上昇率は,CKDの罹患率増加に寄与しています.
この傾向は,将来の腎不全の発生率とCKDの合併症について懸念を喚起しています.

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