Atrial Fibrillation ; complications ; epidemiology ; Humans ; Renal Insufficiency, Chronic ; complications ; epidemiology

Chronic kidney disease (CKD) has become a serious public health concern that endangers human health on a global scale. In China, the prevalence of CKD in adults is 10.8%; however, public awareness and the diagnostic rates of CKD in the Chinese population are relatively low. Moreover, China has not yet established a national CKD screening system or developed standardized diagnostic protocols and treatment pathways. Therefore, there is an urgent need to strengthen the prevention and control of CKD and promote the management of this disease. These guidelines were initiated by the Chinese Preventive Medicine Association for Kidney Disease. The quality of evidence and guideline recommendation were determined by applying the Oxford Centre for Evidence-Based Medicine (CEBM) System. These new guidelines describe 38 recommendations that aim to standardize the early screening, management, diagnosis and treatment of CKD, thus promoting the integrated prevention and control of kidney disease in China.
Adult ; Humans ; Renal Insufficiency, Chronic/therapy* ; Prevalence ; China/epidemiology*

Animals ; Dyslipidemias ; embryology ; physiopathology ; Humans ; Renal Insufficiency, Chronic ; epidemiology ; physiopathology ; therapy ; Renal Replacement Therapy

Chronic kidney disease (CKD) is suffered progressive loss of kidney function lasting more than 3 months and is classified according to the degree of kidney damage (level of proteinuria) and the decreased glomerular filtration rate (GFR). The most severe form of CKD is end-stage renal disease. The prevalence of CKD is high with fast growth rate and the disease burden has become increasingly serious. CKD has become an important public health problem threatening human health. The etiology of CKD is complex. In addition to genetic factors, environmental factors are an important cause of CKD. With the development of industrialization, environmental metal pollution has become increasingly severe, and its impact on human health has received widespread attention. A large number of studies have shown that metals such as lead, cadmium, and arsenic can accumulate in the kidney, which can cause damage to the structure and function of the kidney, and play an important role in the development of CKD. Therefore, summarizing the epidemiological research progress in the relationship between arsenic, cadmium, lead, and other metal exposures and kidney diseases can provide new ideas for the prevention and control of kidney diseases caused by metal exposure.
Humans ; Cadmium/toxicity* ; Arsenic/toxicity* ; Kidney ; Renal Insufficiency, Chronic/epidemiology* ; Kidney Failure, Chronic

INTRODUCTIONChronic kidney disease (CKD) is a major public health problem where majority of patients are managed in the primary care. The major risk factors are advanced age, hypertension and diabetes mellitus, and risk factors control is paramount to prevent progression to CKD. The objective of the study is to describe the epidemiology and quality of care of patients with CKD stages 3 to 5 at National Healthcare Group Polyclinics (NHGP).

MATERIALS AND METHODSThe study was carried out using data from National Healthcare Group (NHG) Renal Registry. Patients were included if they were identified to have CKD based on ICD-9-CM codes and laboratory results.

RESULTSOverall, the number of CKD patients increased more than 2 fold from 4734 in 2007 to 10,245 in 2011. In 2011, the majority belonged to stages 3A (39.6%) and 3B (37.6%), had hypertension (98.2%), dyslipidemia (97.2%) and diabetes mellitus (68.7%). From 2007 to 2011, among those with hypertension, the use of angiotensin converting enzyme (ACE) inhibitors and/ or angiotensin receptor blockers increased from 78.4% to 84.1%, and the percentage with good systolic blood pressure control (<130 mmHg) improved from 18.7% to 36.3%. Among those with dyslipidemia, the use of statins increased from 81% to 87.1%, and the percentage of patients with low density lipoproteins (LDL) <2.6 mmol/L increased from 40% to 54.7%. However, among those with diabetes mellitus, mean glycated haemoglobin (HBA1c) increased from 7.4% to 7.6%, and the percentage of patients with HBA1c ≤7.0% decreased from 44.5% to 39.4%.

CONCLUSIONThe number of CKD patients in NHGP has increased significantly from 2007 to 2011 at an average annual rate of 21.3%. Majority of patients the study conducted in 2011 were in stage 3A and stage 3B. Blood pressure and LDL control are encouraging but glycaemic control can be further improved.

Humans ; Primary Health Care ; Quality of Health Care ; Registries ; Renal Insufficiency, Chronic ; drug therapy ; epidemiology ; Singapore ; epidemiology

With worldwide epidemic of diabetes mellitus, diabetic nephropathy which is one of the major causes of microvascular complication has become a serious concern in Korea as well as the rest of the world. In view of its significance, there is an urgent and paramount need for proper managements that could either deter or slow the progression of diabetic nephropathy. Despite advances in care, ever increasing number of patients suffering from diabetic kidney disease and from end-stage renal disease implies that the current management is not adequate in many aspects. The reasons for these inadequacies compromise lack of early diagnosis, failure to intervene with timely and aggressive manner, and lack of understanding on the kind of interventions required. Another issue equally important for the adequate care of patients with diabetic nephropathy is an understanding of past, present and future epidemiology of diabetic nephropathy which serves, especially in Korea, as a material determining standard diagnosis and treatment and a national health-policy decision.
Diabetes Mellitus ; Diabetic Nephropathies* ; Diagnosis ; Early Diagnosis ; Epidemiology* ; Humans ; Kidney Failure, Chronic ; Korea ; Renal Insufficiency, Chronic ; Renal Replacement Therapy

OBJECTIVETo investigate the prevalence of chronic kidney disease (CKD) in subjects with different glucose metabolism status.

METHODSBetween January, 2015 and October, 2015, a total of 934 subjects without a previous diagnosis of diabetes visiting the Department of Endocrinology or Health Examination Center underwent oral glucose tolerance test (OGTT), which identified 266 subjects with normal glucose tolerance (NGT group), 243 pre-diabetic subjects, and 425 patients with diabetes mellitus group. The baseline characteristics and laboratory test data of the subjects were collected. The diagnosis of CKD was established for an eGFR <60 mL/min/1.73 m(2) or a ACR≥30 mg/g, and the prevalence of CKD were compared among the 3 groups. Logistic regression model was used to analyze the OR value of the risk factors of CKD.

RESULTSThe prevalences of CKD in NGT, pre-diabetic and diabetic groups were 10.2%, 26.3% and 32.5%, respectively. Pairwise comparisons showed that the prevalence of CKD was significantly higher in pre-diabetic group (P<0.001, OR=3.17, 95% CI 1.94-5.17) and diabetic group (P<0.001, OR=4.27, 95% CI 2.72-6.65) than in NGT group, and was comparable between the pre-diabetic and diabetic groups (P=0.115, OR=1.35, 95% CI 0.95-1.91). Logistic regression analysis, after adjustment for age, gender, blood pressure, hypertension, blood lipids and uric acid, showed that pre-diabetes (OR=2.03, P=0.044) and diabetes mellitus (OR=2.22, P=0.016) were independently associated with CKD.

CONCLUSIONGlucose metabolism status has a significant independent impact on the incidence of CKD, suggesting the importance of early detection of pre-diabetes and timely interventions in pre-diabetic subjects in prevention CKD.

Diabetes Mellitus ; epidemiology ; Glucose ; metabolism ; Glucose Tolerance Test ; Humans ; Incidence ; Prediabetic State ; epidemiology ; Prevalence ; Renal Insufficiency, Chronic ; epidemiology ; Risk Factors

BACKGROUNDThe prevalence of chronic kidney disease (CKD) and prediabetes has increased in China, and at different rates in different locations. Therefore a community-based screening research was conducted in order to determine the prevalence of CKD and prediabetes, and to analyze associated risk factors of CKD and prediabetes in a city of Southern China.

METHODSA total of 7801 community residents aged 18 year and older from 6 communities were screened by a stratified random cluster sampling method. An estimated glomerular filtration rate (eGFR), albuminuria, fasting plasma glucose (FPG), and homeostatic model assessment of insulin resistance (HOMA-IR) were measured. Age-standardized prevalence was calculated by the direct method with the use of data on the population distribution in China in 2006. Multivariate logistic analysis was used to analyze the risk factors of CKD and prediabetes, and association of insulin resistance (IR) with CKD and prediabetes was analyzed.

RESULTSThe age-standardized prevalence of CKD was 12.5%, eGFR < 60 ml×min(-1)×1.73 m(-2) was 2.7% and ACR (albumin to creatinine ratio) > 30 mg/g was 10.3%. The age-standardized prevalence of prediabetes was 12.1%. Logistic regression suggests that IR was a common independent risk factor of CKD and prediabetes. Further analysis show that HOMA-IR was increased with the aggravation of kidney injury and FPG.

CONCLUSIONCKD and prediabetes have become a major public health problem in Zhuhai, Southern China; insulin resistance may be an important risk factor.

Adult ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prediabetic State ; epidemiology ; Prevalence ; Renal Insufficiency, Chronic ; epidemiology ; Risk Factors ; Surveys and Questionnaires

Objective: To understand the prevalence of chronic kidney disease (CKD) and related factors in adults in Anhui province based on the data of Chinese Chronic Diseases and Nutrition Surveillance program (2018) in Anhui. Methods: Multi-stage stratified cluster random sampling was used to select participants aged ≥18 years. Moreover, questionnaire survey, body measurements and laboratory tests were conducted. The complex weighting method was used to estimate the prevalence of CKD in residents with different characteristics, and complex sampling data logistic regression model was used for multivariate analysis to identify related risk factors. Results: A total of 7 181 participants were included. The overall prevalence of CKD was 11.06% in adults in Anhui, and the prevalence was 12.49% in women and 9.59% in men (P<0.05). The moderate, high and very high risk for CKD progression were 8.66%, 2.02% and 0.38%, respectively. Multivariate analysis showed that age (OR=1.03, 95%CI: 1.00-1.05), BMI (OR=1.05, 95%CI: 1.01-1.09), being woman (OR=1.38,95%CI: 1.22-1.55), hypertension (OR=2.50, 95%CI: 1.76-3.56), diabetes (OR=2.28, 95%CI: 1.51-3.43), dyslipidemia (OR=1.26, 95%CI: 1.11-1.43) and hyperuricemia (OR=2.16, 95%CI: 1.68-2.78) were risk factors for CKD. Conclusion: The prevalence of CKD in adults in Anhui was relatively high and age, gender, BMI, hypertension, diabetes, dyslipidemia and hyperuricemia were found to be associated with the prevalence of CKD. To prevent CKD and its complications, attention should be paid to the management of related risk factors, including overweight and obesity, hypertension, diabetes, dyslipidemia and hyperuricemia.
Adult ; Male ; Female ; Humans ; Adolescent ; Cross-Sectional Studies ; Prevalence ; Hyperuricemia/epidemiology* ; Renal Insufficiency, Chronic/epidemiology* ; Hypertension/epidemiology*

The creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation can be calculated according to race, sex, and creatinine concentration (subgroup equation) or in the form expressed by one equation (single equation). Minor differences in the constants used in the CKD-EPI equations (subgroup vs single equations) could result in a significant difference in the estimated glomerular filtration rate (eGFR). We evaluated the impact of this difference in 79,709 Korean patients. The eGFR was calculated as an integer using the single and subgroup CKD-EPI equations. The differences in eGFR and GFR categories between the equations were analyzed. eGFR was higher in the subgroup equation than the single equation by 1 mL/min/1.73 m² for 12,476 (27.4%) Korean females. The GFR category based on the subgroup equation was reclassified using the single equation for 352 (0.77%) females. Based on the results, the constant of the single equation was optimized. There was no difference in eGFR values between equations using a multiplier of 1.0213 instead of 1.018 for the “white or other” females constant in the single CKD-EPI equation. Clinicians should carefully apply the CKD-EPI equation because eGFR values may differ by 1 mL/min/1.73 m² depending on the manner of calculation. To minimize these differences, the constants of the single equation should be revised.
Continental Population Groups ; Cooperative Behavior ; Creatinine ; Epidemiology ; Female ; Glomerular Filtration Rate ; Humans ; Renal Insufficiency, Chronic