Lancet：中国慢性肾脏病流行病学调查数据公布，中国高达1.2亿人

Luxia Zhang MD a *, Fang Wang MD a *, Prof Li Wang MD b †, Prof Wenke Wang MD c †, Prof Bicheng Liu MD d †, Prof Jian Liu MD e †, Prof Menghua Chen MD f †, Prof Qiang He MD g †, Prof Yunhua Liao MD h †, Prof Xueqing Yu MD i †, Prof Nan Chen MD j †, Prof Jian-e Zhang MD k, Prof Zhao Hu MD l, Prof Fuyou Liu MD m, Daqing Hong MD b, Lijie Ma MD c, Hong Liu MD d, Xiaoling Zhou MD f, Jianghua Chen MD g, Ling Pan MD h, Wei Chen MD i, Weiming Wang MD j, Prof Xiaomei Li MD a, Prof Haiyan Wang MD a

Background The prevalence of chronic kidney disease is high in developing countries. However, no national survey of chronic kidney disease has been done incorporating both estimated glomerular filtration rate (eGFR) and albuminuria in a developing country with the economic diversity of China. We aimed to measure the prevalence of chronic kidney disease in China with such a survey.

Methods We did a cross-sectional survey of a nationally representative sample of Chinese adults. Chronic kidney disease was defined as eGFR less than 60 mL/min per 1·73 m2 or the presence of albuminuria. Participants completed a lifestyle and medical history questionnaire and had their blood pressure measured, and blood and urine samples taken. Serum creatinine was measured and used to estimate glomerular filtration rate. Urinary albumin and creatinine were tested to assess albuminuria. The crude and adjusted prevalence of indicators of kidney damage were calculated and factors associated with the presence of chronic kidney disease analysed by logistic regression.

Findings 50 550 people were invited to participate, of whom 47 204 agreed. The adjusted prevalence of eGFR less than 60 mL/min per 1·73 m2 was 1·7% (95% CI 1·5—1·9) and of albuminuria was 9·4% (8·9—10·0). The overall prevalence of chronic kidney disease was 10·8% (10·2—11·3); therefore the number of patients with chronic kidney disease in China is estimated to be about 119·5 million (112·9—125·0 million). In rural areas, economic development was independently associated with the presence of albuminuria. The prevalence of chronic kidney disease was high in north (16·9% [15·1—18·7]) and southwest (18·3% [16·4—20·4]) regions compared with other regions. Other factors independently associated with kidney damage were age, sex, hypertension, diabetes, history of cardiovascular disease, hyperuricaemia, area of residence, and economic status.

Interpretation Chronic kidney disease has become an important public health problem in China. Special attention should be paid to residents in economically improving rural areas and specific geographical regions in China.

Funding The Ministry of Science and Technology (China); the Science and Technology Commission of Shanghai; the National Natural Science Foundation of China; the Department of Health, Jiangsu Province; the Sichuan Science and Technology Department; the Ministry of Education (China); the International Society of Nephrology Research Committee; and the China Health and Medical Development Foundation.