在未被诊断的糖尿病和高血压患者中查CKD:来自SEARCH研究的经验教训
Thyago Proença de Moraes1, Ana Flavia Moura2, Andrei C Sposito3
1Pontifícia Universidade Católica do Paraná, Curitiba, PA, Brazil.
Jornal brasileiro de nefrologia
|January 27, 2026
概括
巴西的一项查活动发现,近20%的高危人群患有未诊断的慢性病 (CKD). 通过白蛋白尿检测早期检测至关重要,但未得到充分利用,错失了干预机会.
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) 诊断和风险分层构成重大挑战,尽管管理方面取得了进展.
- 巴西国家查活动的目标是高风险的个人,他们不知道自己的CKD状态.
- 这项研究的目的是估计CKD的患病率,并分析估计的淋巴细胞过率 (eGFR) 的纵向趋势.
研究的目的:
- 在巴西高风险人口中估计以前未被诊断的慢性病 (CKD) 的患病率.
- 评估参与者估计的膜过率 (eGFR) 的纵向趋势.
- 为了确定与CKD相关的风险因素,并评估使用白色素尿检测的使用情况.
主要方法:
- 这是一项对14239名患有糖尿病和/或动脉高血压的成年人进行的横截式观察性研究.
- 收集的数据包括人口统计,临床因素,血清肌氨酸和白蛋白与肌氨酸比率 (ACR).
- 使用KDIGO标准进行CKD分期;使用CKD-EPI 2021计算eGFR. 混合效应模型和后勤回归分析了eGFR轨迹和风险因素.
主要成果:
- 在19.6%的参与者中,新确诊的CKD;11.3%的eGFR<60mL/min,11.1%的ACR>30mg/g.
- 专尿 (ACR) 测试的使用不足 (运动前<5%,运动后<7%).
- 在糖尿病患者,高血压患者,老年人以及BMI>25 kg/m2的患者中观察到更急剧的eGFR下降. 预计2年内约有169,000例功能衰竭病例.
结论:
- 在巴西高风险人口中,未被诊断的CKD的高患病率.
- 尽管普遍获得医疗保健,但专尿检测的使用明显不足.
- 不充分利用白蛋白尿检测代表了早期CKD检测和脏保护干预的错失机会.
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