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慢性病有没有错失的机会? 一个区域范围的队列研究
Johan Sundström1,2, Anna Norhammar3,4, Stelios Karayiannides5,6
1Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden johan.sundstrom@uu.se.
BMJ open
|April 20, 2024
概括
慢性病 (CKD) 的早期诊断和治疗为预防不良结果提供了显著的机会. 优化未诊断的CKD患者的指导方针导向治疗可以大大降低死亡率和主要心血管不良事件.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 慢性病 (CKD) 是一个重要的全球健康负担.
- 早期诊断和管理对于预防不良结果至关重要.
- 未被诊断和治疗不足的CKD有助于过度的发病率和死亡率.
研究的目的:
- 确定诊断CKD和预防其不良结果的机会.
- 量化早期CKD预防策略对人口水平的潜在益处.
- 评估目前未被诊断的CKD的诊断和治疗模式.
主要方法:
- 从2015年到2020年,在瑞典进行了一项全民观测性研究.
- 包括有实验室确认的CKD但没有先前临床诊断的患者.
- 评估的是诊断率,使用指南导向疗法 (他类药物,RAASi,SGLT2i) 和不良结果 (死亡率,MACE).
主要成果:
- 确定了99,382名未被诊断的CKD患者.
- 只有33%的人在5年内得到了诊断.
- 使用他类药物或RAASi的治疗是不理想的;SGLT2i的使用是可以忽略不计的.
- 模拟表明22-39%的不良结果可以通过最佳治疗来避免.
结论:
- 在当代人群中,CKD的诊断不足和治疗不足显著.
- 以指导方针为导向的药理疗法的早期干预具有改善CKD结果的巨大潜力.
- 实施有效的CKD管理策略可以减少疾病的整体负担.
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