1990 至 2019 年全球、地区和国家层面慢性肾脏病的疾病负担和流行病学趋势。

IF 2.3 4区 医学 Q2 UROLOGY & NEPHROLOGY
Nephron Pub Date : 2024-01-01 Epub Date: 2023-09-15 DOI:10.1159/000534071
Meike Ying, Xue Shao, Hongli Qin, Pei Yin, Yushi Lin, Jie Wu, Jingjing Ren, Yang Zheng
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引用次数: 0

摘要

背景:慢性肾脏病(CKD)是全球严重的公共卫生问题:慢性肾脏病(CKD)是全球严重的公共卫生问题,但不同病因导致的CKD疾病负担和变化趋势尚未得到充分研究:我们收集了2019年全球疾病负担研究(GBD 2019)的数据,包括1990年至2019年间按地区、病因、年龄和性别划分的发病病例、年龄标准化发病率(ASIR)、残疾调整生命年(DALYs)和年龄标准化DALY率,并计算了该比率的估计年百分比变化(EAPC),以评估流行病学趋势:在全球范围内,CKD 的发病病例从 1990 年的 780 万例增加到 2019 年的 1899 万例,DALY 从 2150 万增加到 4154 万。ASIR增加的EAPC为0.69(95%不确定区间[UI] 0.49-0.89),2019年达到每10万人233.65例,而年龄标准化DALY率增加的EAPC为0.30(95%不确定区间[UI] 0.17-0.43),达到每10万人514.86例。北非和中东、拉丁美洲中部和北美洲在 2019 年的 ASIR 最高。同时,拉丁美洲中部的年龄标准化残疾调整寿命年率最高。从1990年到2019年,几乎所有国家的ASIR都在增加,超过50%的国家的年龄标准化DALY率呈上升趋势。2 型糖尿病和高血压导致的 CKD 占疾病负担的最大部分,占 2019 年已知病因中 85% 的发病病例和 66% 的残疾调整寿命年数,年龄标准化残疾调整寿命年数增长率最高,其地理模式与总 CKD 相似。此外,70 岁以上人群是总慢性肾脏病和四种特定慢性肾脏病发病率最高的人群,他们的残疾调整寿命率也最高,且在 2010 年后呈稳定趋势。女性的 ASIR 较高,而男性的年龄标准化 DALY 率较高,其中高血压导致的 CKD 的差距最为明显:结论:在全球范围内,慢性肾功能衰竭的疾病负担仍然很重,而且还在继续增长。从 1990 年到 2019 年,全球 CKD 发病病例增加了一倍多,DALY 几乎增加了一倍,超过了 4000 万年。2 型糖尿病和高血压导致的 CKD 占 2019 年已知病因 DALY 的近 2/3,是年龄标准化 DALY 增长率最高的疾病。针对病因的预防策略应作为精准控制 CKD 目标的重中之重。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disease Burden and Epidemiological Trends of Chronic Kidney Disease at the Global, Regional, National Levels from 1990 to 2019.

Background: Chronic kidney disease (CKD) is a serious public health issue worldwide, but the disease burden of CKD caused by different etiologies and changing trends has not been fully examined.

Methods: We collected data from Global Burden of Disease Study 2019 (GBD 2019), including incident cases, age-standardized incidence rate (ASIR), disability-adjusted life years (DALYs), and age-standardized DALY rate between 1990 and 2019 by region, etiology, age, and sex, and calculated the estimated annual percentage change (EAPC) of the rate to evaluate the epidemiological trends.

Results: Globally, incident cases of CKD increased from 7.80 million in 1990 to 18.99 million in 2019, and DALYs increased from 21.50 million to 41.54 million. ASIR increased with an EAPC of 0.69 (95% uncertainty interval [UI] 0.49-0.89) and reached 233.65 per 100,000 in 2019, while the age-standardized DALY rate increased with an EAPC of 0.30 (95% UI 0.17-0.43) and reached 514.86 per 100,000. North Africa and the Middle East, central Latin America, and North America had the highest ASIR in 2019. Central Latin America had the highest age-standardized DALY rate, meanwhile. Almost all countries experienced an increase in ASIR, and over 50% of countries had an increasing trend in age-standardized DALY rate from 1990 to 2019. CKD due to diabetes mellitus type 2 and hypertension accounted for the largest disease burden with 85% incident cases and 66% DALYs in 2019 of known causes, with the highest growth in age-standardized DALY rate and a similar geographic pattern to that of total CKD. Besides, the highest incidence rate of total and four specific CKDs were identified in people aged 70 plus years, who also had the highest DALY rate with a stable trend after 2010. Females had a higher ASIR, while males had a higher age-standardized DALY rate, the gap of which was most distinctive in CKD due to hypertension.

Conclusion: The disease burden of CKD remains substantial and continues to grow globally. From 1990 to 2019, global incident cases of CKD have more than doubled and DALYs have almost doubled, and surpassed 40 million years. CKD due to diabetes mellitus type 2 and hypertension contributed nearly 2/3 of DALYs in 2019 of known causes, and had witnessed the highest growth in age-standardized DALY rate. Etiology-specific prevention strategies should be placed as a high priority on the goal of precise control of CKD.

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来源期刊
Nephron
Nephron UROLOGY & NEPHROLOGY-
CiteScore
5.00
自引率
0.00%
发文量
80
期刊介绍: ''Nephron'' comprises three sections, which are each under the editorship of internationally recognized leaders and served by specialized Associate Editors. Apart from high-quality original research, ''Nephron'' publishes invited reviews/minireviews on up-to-date topics. Papers undergo an innovative and transparent peer review process encompassing a Presentation Report which assesses and summarizes the presentation of the paper in an unbiased and standardized way.
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